MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Heart Failure Reviews' source. Wed, 08 Feb 2012 09:32:41 +0100 http://www.medworm.com/index.php?rid=5638315&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa62403n518815653%2F Abstract  Significant growth in the elderly population (age ≥ 65 years) with heart failure (HF) has taken place in developed countries and is occurring in most developing countries. Projections from population studies in the United States, Europe and other developed countries suggest that this trend will very likely continue and tax healthcare systems worldwide. Prevention of HF in the elderly should be a healthcare priority. Preventive strategies are urgently needed to combat the rising burden of HF and related complications in elderly men and women of tomorrow. The strategies should address the aging continuum and the cumulative impact of lifelong exposure to cardiovascular (CV) risk factors and consider the associated pathobiology and pathophysiology of ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5638315 Tue, 24 Jan 2012 07:20:23 +0100 5638315 http://www.medworm.com/index.php?rid=5619896&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb8668211483lr985%2F Abstract  Dilated cardiomyopathy (DCM) is a common debilitating condition with limited therapeutic options besides heart transplantation or palliation. It is characterized by maladaptive remodeling of cardiomyocytes, extracellular collagen matrix (ECCM) and left ventricular (LV) geometry which contributes to further dysfunction. LV assist devices (LVADs) can reverse adverse remodeling in end-stage DCM. However, there is a disconnect between the benefits of prolonged unloading with LVAD at molecular and cellular levels and the low rate of bridge to recovery (BTR). Potential explanations for this paradox include insufficient reverse ECCM remodeling and/or excessive reverse cardiomyocyte remodeling with atrophy. LVAD therapy is associated with decreased collagen turnover and c... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5619896 Thu, 19 Jan 2012 06:54:52 +0100 5619896 http://www.medworm.com/index.php?rid=5619895&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F338240m2121n077n%2F Content Type Journal ArticlePages 1-2DOI 10.1007/s10741-012-9301-7Authors Bodh I. Jugdutt, Department of Medicine, Division of Cardiology, University of Alberta and Hospitals, 2C2 Walter MacKenzie Health Sciences Centre, Edmonton, AB T6G 2R7, Canada Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5619895 Thu, 19 Jan 2012 06:54:52 +0100 5619895 http://www.medworm.com/index.php?rid=5619897&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa458714g0w415210%2F Abstract  Surgical reconstruction of physiological shape and size of a postischemically remodeled left ventricle has been advocated to improve ventricular function and improve patient long-term outcome. What initially started as linear aneurysm resection surgery developed over the years into the endoventricular repair techniques (surgical ventricular reconstruction, SVR) that have also been applied in patients with postischemically dilated ventricles and mainly anterior akinesia. SVR improved function as measured by the ejection fraction. Whether it affects survival was finally tested in the largest surgical trial ever conducted, the STICH trial (Surgical Treatment for IsChemic Heart failure). The trial, however, presented rather sobering information with its Hypothesis 2 o... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5619897 Thu, 19 Jan 2012 06:54:51 +0100 5619897 http://www.medworm.com/index.php?rid=5597172&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr26161232035l8j3%2F Abstract  End-stage systolic heart failure is an increasingly common problem in elderly patients and is associated with high cost, poor quality of life, and poor outcomes. Mechanical circulatory support is a promising therapy as both a bridge to transplantation and destination therapy. Elderly patients are frequently ineligible for heart transplantation because of their age and comorbidities, and the application of mechanical circulatory support for destination therapy in this population is not well defined. A review of the literature was undertaken to better characterize our experience to date with mechanical circulatory support in older heart failure populations. Mechanical circulatory support is being employed increasingly for destination therapy indications in older pat... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5597172 Wed, 11 Jan 2012 17:57:58 +0100 5597172 http://www.medworm.com/index.php?rid=5572067&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv84887v88l04h4t2%2F Abstract  Heart failure syndromes are often associated with multi-organ dysfunction, and concomitant liver, renal, and neurologic involvement is very common. Neuro-hormonal antagonism plays a key role in the management of this syndrome, and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are one of the cornerstones of therapy. Cardiorenal physiology is becoming more recognized in these patients with advanced heart failure, and the role of neuro-hormonal blockade in this setting is vaguely defined in the literature. Often, angiotensin-converting enzyme inhibitors are decreased or even withheld in these circumstances. The purpose of this article is to review the role and pathophysiology of ace inhibition and angiotensin receptor blockade in patients... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5572067 Mon, 02 Jan 2012 16:48:16 +0100 5572067 http://www.medworm.com/index.php?rid=5504586&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fqq887066065n7v28%2F Abstract  Clinical trials for acute heart failure syndromes (AHFS) have traditionally enrolled patients well after emergency department (ED) presentation. We hypothesized a large proportion of patients would undergo changes in clinical profiles during the first 24 h of hospitalization, and these changes would be associated with adverse events. We evaluated a prospective cohort of patients with clinical data available at ED presentation and 12–24 h after ED treatment for AHFS. Patients were categorized into distinct clinical profiles at these time points based on (1) systolic blood pressure: a—hypertensive (>160 mmHg); b—normotensive (100–159 mmHg); or c—hypotensive (<100 mmHg); (2) moderate-to-severe renal dysfunction (GFR ≤&nb... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5504586 Mon, 12 Dec 2011 17:06:40 +0100 5504586 http://www.medworm.com/index.php?rid=5476319&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk7141kr14n614802%2F Abstract  Self-care is an important aspect of heart failure (HF) management. Information on the determinants of self-care is necessary for the development of self-care promotion interventions. HF self-care includes self-care management, self-care maintenance, sodium, fluid and alcohol intake restriction, physical activity, smoking cessation, monitoring signs and symptoms and keeping follow-up appointments. To assess the evidence regarding presumed determinants of HF self-care and make recommendations for interventions to promote self-care behavior among HF patients, a systematic literature review was conducted. Based on inclusion and exclusion criteria and a quality assessment, twenty-six articles were included. A best evidence synthesis was used. Results showed that the le... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5476319 Thu, 01 Dec 2011 19:22:39 +0100 5476319 http://www.medworm.com/index.php?rid=5431571&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd71612jl136116lu%2F Abstract  Aging is a well-recognized risk factor in the development of cardiovascular disease, which is the primary cause of death and disability in the elderly population. The normal process of aging is associated with progressive deterioration in structure and function of the heart and vasculature. These age-related changes likely act as both a catalyst and accelerator in the development of cardiovascular disease. Since the aging population is one of the fastest growing segments of the population, it is of vital importance that we have a thorough understanding of the physiological changes that occur with aging that contribute to the high incidence of cardiovascular disease in this population. This insight will allow for the development of more targeted therapies that can ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5431571 Fri, 18 Nov 2011 06:59:13 +0100 5431571 http://www.medworm.com/index.php?rid=5421833&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd05011n981285150%2F Abstract  There has been increasing interest on the so-called cardiorenal syndrome (CRS), defined as a complex pathophysiological disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other. In this review, we contend that there is lack of evidence warranting the adoption of a specific clinical construct such as the CRS within the heart failure (HF) syndrome by demonstrating that: (a) the approaches and tools regarding the definition of kidney involvement in HF are suboptimal; (b) development of renal failure in HF is often confounded by age, hypertension, and diabetes; (c) worsening of renal function (WRF) in HF may be largely independent of alterations in cardiac function; (d) the bidirectional a... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5421833 Tue, 15 Nov 2011 17:00:44 +0100 5421833 http://www.medworm.com/index.php?rid=5407569&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fcm92253w62561308%2F Abstract  The purpose of treatment is to alter outcomes favourably. From a clinical perspective, these outcomes may include symptoms, quality of life, disability, morbidity and mortality. However, a good outcome does not mean that the intervention was effective and a seemingly poor outcome could have been worse without intervention. Patients may have a good outcome either because their disease was due to run a benign course, or because they responded to the intended treatment or because they responded to some other ancillary treatment. Clearly, there is a link between response and outcome but it is loose and uncertain. The clinical substrate being treated is often a stronger determinant of outcome than the response to the intervention. The concepts of outcome and response c... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5407569 Fri, 11 Nov 2011 12:48:11 +0100 5407569 http://www.medworm.com/index.php?rid=5386026&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl8q231271379q336%2F Abstract  Recently, it has been suggested that erythropoietin may be useful in the treatment of cardiovascular disease, particularly heart failure. This may be by improving microvascular blood supply and ventricular function through prevention of apoptosis and angiogenesis. Promising results were seen in animals but the few, limited clinical trials have shown modest benefits. Additionally, concerns exist regarding potential serious adverse effects of erythropoietin. Our current understanding of the non-haematopoietic mechanisms of erythropoietin is presented here, with a review of trials to date, and a discussion of the questions that remain over the use of this drug in heart failure. Content Type Journal ArticlePages 1-9DOI 10.1007/s10741-011-9288-5Authors Lindsey Ti... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5386026 Fri, 04 Nov 2011 05:43:39 +0100 5386026 http://www.medworm.com/index.php?rid=5386027&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F18mv0726580v4856%2F Abstract  Atrial fibrillation (AF) is a common clinical problem in elderly patients and especially in those with heart failure (HF). It is a major risk factor for serious cardiovascular events, such as stroke, HF and premature death. Both the prevalence and incidence of AF increase with age and its prevalence in the United States are estimated at more than 2.2 million, with nearly 75% of patients aged >65 years. Aging-related atrial remodeling with fibrosis, dilation and mitochondrial DNA mutations predispose elderly patients to AF. Current management options for AF, including rate control and anticoagulation therapy, can be successfully applied to the elderly population. New antiarrhythmic and anticoagulation medications such as dronedarone and dabigatran, respecti... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5386027 Thu, 03 Nov 2011 16:57:49 +0100 5386027 http://www.medworm.com/index.php?rid=5335444&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr27774341p607268%2F Abstract  Cardiac resynchronisation therapy (CRT), by retiming the failing heart, improves symptoms, reduces hospitalisations and improves survival in patients with left ventricular dysfunction and QRS prolongation. However, not all patients “respond” to CRT. Successful CRT depends on appropriate patient selection, optimal lead positioning, device programming/optimisation and optimal medical therapy. This review article focuses on the importance of lead positioning in improving outcomes. Content Type Journal ArticlePages 1-9DOI 10.1007/s10741-011-9287-6Authors Peter J. Cowburn, Wessex Cardiac Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UKChristophe Leclercq, Départment de Cardiologie et Maladies Vasculaires, CHU, Pontchaillou, 2, rue Hen... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5335444 Wed, 19 Oct 2011 05:50:28 +0100 5335444 http://www.medworm.com/index.php?rid=5335445&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3088k721676m4500%2F Abstract  The aging population with hypertension and coronary artery disease is rapidly increasing worldwide and develops heart failure (HF). A wide range of pharmacotherapeutic drugs are recommended in the HF management guidelines. For the most part, these recommendations are based on the results of studies in the younger population, and most drugs were not adequately tested in the elderly. However, many changes that occur during the aging process affect the response to several of the recommended therapeutic drugs. Physicians will be increasingly involved in managing the expanding elderly population with HF. It is therefore imperative that they recognize ways to use current pharmacotherapeutic agents and the increasing need for novel agents for optimizing the management of... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5335445 Sun, 16 Oct 2011 15:37:42 +0100 5335445 http://www.medworm.com/index.php?rid=5323827&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr9k5200321642788%2F Abstract  Aortic atherosclerosis reduces compliance in the systemic circulation and increases peripheral resistance, afterload and left ventricular wall stress. In patients with heart failure, these changes can impair left ventricular systolic function and energy efficiency, which could reduce exercise capacity. Though the interaction and the impact of aortic atherosclerosis on left ventricular function have been investigated, its prognostic implications in patients with heart failure are unclear. We used cardiac magnetic resonance imaging and gadolinium-enhanced abdominal aortography to investigate the prevalence and prognostic impact of atherosclerotic disease of the abdominal aorta and its side branches in 355 patients with heart failure. Sclerotic abdominal aortic disea... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5323827 Fri, 14 Oct 2011 10:39:26 +0100 5323827 http://www.medworm.com/index.php?rid=5323828&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq123r2401g134173%2F Abstract  Chronic heart failure (CHF) patients frequently experience impaired exercise tolerance due to skeletal muscle fatigue. Studies suggest that this in part is due to intrinsic alterations in skeletal muscle of CHF patients, often interpreted as a disease-specific myopathy. Knowledge about the mechanisms underlying these skeletal muscle alterations is of importance for the pathophysiological understanding of CHF, therapeutic approach and rehabilitation strategies. We here critically review the evidence for skeletal muscle alterations in CHF, the underlying mechanisms of such alterations and how skeletal muscle responds to training in this patient group. Skeletal muscle characteristics in CHF patients are very similar to what is reported in response to chronic obstruct... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5323828 Fri, 14 Oct 2011 05:50:39 +0100 5323828 http://www.medworm.com/index.php?rid=5323829&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp9634496611055p6%2F Abstract  Mineralocorticoid receptor antagonists (MRAs) have been effective in reducing total mortality in patients with heart failure (HF) and a reduced left ventricular ejection fraction. Due to the finding that aldosterone levels decrease with age, one might question the effectiveness of MRAs in very old patients (≥80 years of age), those at the greatest risk for developing HF with a preserved left ventricular ejection fraction (PEF). However, while aldosterone levels decrease with age, there is also a decrease in the enzyme 11 beta HSD2 levels with age, thereby allowing cortisol to stimulate the mineralocorticoid receptor (MR), which in younger patients with higher levels of 11 beta HSD 2 levels is converted to cortisone which cannot activate the MR. There is als... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5323829 Fri, 14 Oct 2011 05:50:38 +0100 5323829 http://www.medworm.com/index.php?rid=5304257&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F805u23qut328h334%2F Abstract  Cardiovascular diseases remain the first cause of morbidity and mortality in the developed countries and are a major problem not only in the western nations but also in developing countries. Current standard approaches for treating patients with ischemic heart disease include angioplasty or bypass surgery. However, a large number of patients cannot be treated using these procedures. Novel curative approaches under investigation include gene, cell, and protein therapy. This review focuses on potential growth factors for cardiac repair. The role of these growth factors in the angiogenic process and the therapeutic implications are reviewed. Issues including aspects of growth factor delivery are presented in relation to protein stability, dosage, routes, and safety m... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5304257 Fri, 07 Oct 2011 05:47:20 +0100 5304257 http://www.medworm.com/index.php?rid=5304258&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff316417764522t31%2F This article aims to review the aspects of anemia in chronic HF that are relevant for making treatment decisions, beginning with the definition of anemia and its incidence and prevalence of anemia in patients with chronic HF. Considering the etiology and prognostic impact of anemia in chronic HF, several treatment options will be considered. The latter are the application of erythropoiesis-stimulating agents (erythropoietin or darbepoetin alfa) or in the application of intravenous iron (e.g., iron carboxymaltose). According to the results seen in the FAIR-HF trial, iron supplementation should be particularly considered to improve symptoms and quality of life. Intravenous iron application may result in higher compliance and much faster treatment response than oral iron. The RED-HF stu... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5304258 Fri, 07 Oct 2011 05:47:19 +0100 5304258 http://www.medworm.com/index.php?rid=5260421&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp210857up7668204%2F Content Type Journal ArticlePages 1-5DOI 10.1007/s10741-011-9281-zAuthors Laszlo Buga, Academic Cardiology, University of Hull, Castle Hill Hospital, MRTDS Building, Castle Road, Cottingham, Kingston-upon-Hull, HU16 5JQ UKJohn GF Cleland, Academic Cardiology, University of Hull, Castle Hill Hospital, MRTDS Building, Castle Road, Cottingham, Kingston-upon-Hull, HU16 5JQ UK Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5260421 Tue, 20 Sep 2011 05:48:49 +0100 5260421 http://www.medworm.com/index.php?rid=5260422&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fnp102333g82n6716%2F The objectives of this study were to describe the baseline, in-hospital, and post-discharge clinical, laboratory, and neurohormonal profiles of patients hospitalized for worsening heart failure with reduced ejection fraction (EF) who die or are re-admitted for cardiovascular (CV) causes within 90 days of initial hospitalization. Retrospective analysis of 4,133 patients hospitalized for worsening heart failure with EF ≤40% in the Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study with Tolvaptan (EVEREST) trial, which randomized patients to tolvaptan or placebo, both in addition to standard therapy. Clinical and laboratory parameters were obtained within 48 h of admission, during hospitalization, and post-discharge weeks 1, 4, 8, and every 8 weeks thereafter... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5260422 Tue, 20 Sep 2011 05:46:43 +0100 5260422 http://www.medworm.com/index.php?rid=5225185&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F84q0624148742586%2F Abstract  The incidence of heart failure and renal failure is increasing and is associated with poor prognosis. Moreover, these conditions do often coexist and this coexistence results in worsened outcome. Various mechanisms have been proposed as an explanation of this interrelation, including changes in hemodynamics, endothelial dysfunction, inflammation, activation of renin-angiotensin-aldosterone system, and/or sympathetic nervous system. However, the exact mechanisms initializing and maintaining this interaction are still unknown. In many experimental studies on cardiac or renal dysfunction, the function of the other organ was either not addressed or the authors failed to show any decline in its function despite histological changes. There are few studies in which the d... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5225185 Sat, 10 Sep 2011 05:46:22 +0100 5225185 http://www.medworm.com/index.php?rid=5161401&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe4676450555548u2%2F This article is intended to discuss that cardiac dysfunction in hearts failing due to myocardial infarction and aging is associated with cardiac remodeling and defects in the subcellular organelles such as sarcolemma (SL), sarcoplasmic reticulum (SR), and myofibrils. Despite some differences in the pattern of heart failure due to myocardial infarction and aging with respect to their etiology and sequence of events, evidence has been presented to show that subcellular remodeling plays a critical role in the occurrence of intracellular Ca2+-overload and development of cardiac dysfunction in both types of failing heart. In particular, alterations in gene expression for SL and SR proteins induce Ca2+-handling abnormalities in cardiomyocytes, whereas those for myofibrillar proteins impair ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5161401 Thu, 18 Aug 2011 05:50:03 +0100 5161401 http://www.medworm.com/index.php?rid=5109204&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv76163n088742j56%2F Abstract  Heart failure may lead to acute kidney injury and viceversa. Chronic kidney disease may affect the clinical outcome in terms of cardiovascular morbidity and mortality while chronic heart failure may cause CKD. All these disorders contribute to the composite definition of cardio-renal syndromes. Renal impairment in HF patients has been increasingly recognized as an independent risk factor for morbidity and mortality; however, the most important clinical trials in HF tend to exclude patients with significant renal dysfunction. The mechanisms whereby renal insufficiency worsens the outcome in HF are not known, and several pathways could contribute to the “vicious heart/kidney circle.” Traditionally, renal impairment has been attributed to the renal hypoperfusion ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5109204 Sat, 06 Aug 2011 05:59:39 +0100 5109204 http://www.medworm.com/index.php?rid=5109205&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0477jg7144385pu7%2F Abstract  Heart failure is an epidemic in the elderly and has become a leading cause for hospitalization and death. Heart failure with preserved ejection fraction (HFPEF) is more common than heart failure with reduced ejection fraction (HFREF) but disease identification remains challenging. Current criteria rely on symptoms of poor exercise tolerance, preserved ejection fraction and laboratory evidence for elevated filling pressures. Each of these clinical parameters is difficult to evaluate in the elderly and reduce the certainty of diagnosis. Aging is associated with changes in the peripheral vasculature, pulmonary function, oxygen transport and skeletal muscle function, all key determinants of exercise capacity. Furthermore, co-morbid conditions such as chronic obstructi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5109205 Fri, 05 Aug 2011 06:02:25 +0100 5109205 http://www.medworm.com/index.php?rid=5109206&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9331g4h11g5v3371%2F Abstract  The decision to implant a CRT or CRT-D device is an important one that requires a careful look at the patient and discussion with the patient as to the benefits and risks associated with each approach. The good news is that CRT provided in any device is a robust therapy that improves many measures of heart failure outcome in very high-risk patients. We argue that in most circumstances, it is much easier to turn a tachycardia device off than not to have the benefit of prompt defibrillation should a tachycardia event occur. While cost is always a consideration, the responsibility of the physician is to individualize patient care and advocate for each patient, based upon the best available therapies. Content Type Journal ArticlePages 1-3DOI 10.1007/s10741-011-927... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5109206 Thu, 04 Aug 2011 15:41:15 +0100 5109206 http://www.medworm.com/index.php?rid=5103802&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8k22w87040341450%2F Abstract  Important changes occur in the cardiovascular system with advancing age, even in apparently healthy individuals. Thickening and stiffening of the large arteries develop due to collagen and calcium deposition and loss of elastic fibers in the medial layer. These arterial changes cause systolic blood pressure to rise with age, while diastolic blood pressure generally declines after the sixth decade. In the left ventricle, modest concentric wall thickening occurs due to cellular hypertrophy, but cavity size does not change. Although left ventricular systolic function is preserved across the age span, early diastolic filling rate declines 30–50% between the third and ninth decades. Conversely, an age-associated increase in late diastolic filling due to atrial contra... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5103802 Tue, 02 Aug 2011 05:52:29 +0100 5103802 http://www.medworm.com/index.php?rid=5088080&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0427251kpm041015%2F Abstract  Left ventricular dyssynchrony (LVD) is common in heart failure patients with LV systolic dysfunction. Contrary to what it could be expected, LVD is not a stable phenomenon. Various conditions (inducible ischemia, exercise, drug administration) may significantly alter the presence and the magnitude of LVD, which could per se modulate response to treatment for heart failure. LVD can be evaluated using validated Doppler-echocardiographic techniques as tissue Doppler imaging. Exercise and dobutamine stress echocardiography can be used tests to unmask LVD. Changes in LV synchronicity during stress test occur independently of inducible ischemia and irrespective of QRS width. The degree of LVD varies substantially from patient to patient. The dynamic increase in LVD repr... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5088080 Fri, 29 Jul 2011 05:54:56 +0100 5088080 http://www.medworm.com/index.php?rid=5088081&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr5736l21p6563807%2F Abstract  Cardiac resynchronization therapy has become a standard therapy for patients who are refractory to optimal medical therapy and fulfill the criteria of QRS >120 ms, ejection fraction <35% and NYHA class II, III or IV. Unless there is some other heretofore unrecognized effect of pacing, the benefits of atrio-biventricular pacing on hard outcomes observed in randomized trials can only be attributed to the physiological changes it induces such as increases in cardiac output and/or reduction in myocardial oxygen consumption leading to an improvement in cardiac function efficiency. The term “Cardiac Resynchronization Therapy” for biventricular pacing presupposes that restoration of synchrony (simultaneity of timing) between left and right ventricles and/o... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5088081 Wed, 27 Jul 2011 18:47:12 +0100 5088081 http://www.medworm.com/index.php?rid=5088082&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F15nw35333146248x%2F Abstract  The function of the right ventricle (RV) in heart failure (HF) has been mostly ignored until recently. A 2006 report of the National Heart, Lung, and Blood Institute identified a gap between RV research efforts and its clinical importance compared with that of the left ventricle. This recent shift in paradigm is fueled by the prognostic value ascribed to RV failure in HF and morbidity/mortality after myocardial infarction and surgery. In this review, we examine the significance of RV failure in the HF setting, its clinical presentation and pathophysiology, and ways to evaluate RV function using echocardiographic measurements. Furthermore, we discuss the medical management of RV failure including traditional therapies like beta-blockers and newer options like nitri... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5088082 Wed, 27 Jul 2011 18:47:11 +0100 5088082 http://www.medworm.com/index.php?rid=5063513&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F465672m0g3848253%2F Abstract  Spectacular developments have taken place, in the last 10 years, in the device-based management of heart failure (HF). Patients presenting with chronic HF may benefit from a device implanted with a view to: (1) resynchronise the pump function of a discoordinated failing heart or (2) prevent sudden arrhythmic death by automatic cardioversion or defibrillation. This “point-of-view” article reviews the large amount of information gathered in the past 10 years on the use of cardiac resynchronisation therapy (CRT), with or without cardioverter defibrillator (ICD), and puts in perspective the advisability of using one, the other or both treatments in distinct patient subsets. There is currently no strong scientific evidence supporting the systematic implant... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5063513 Sat, 23 Jul 2011 15:49:56 +0100 5063513 http://www.medworm.com/index.php?rid=5063514&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0702q17wq134612l%2F Abstract  Although there is little debate over the fact that cardiac resynchronization therapy (CRT) can benefit the majority of patients selected with routine indications, the precise mechanism for improvement may be considered controversial. Among patients selected with New York Heart Association functional class III or IV symptoms, left ventricular ejection fraction ≤35% and electrocardiographic QRS widening of at least 120–130 ms, approximately 60–80% of patients improved depending on the definition of response used. Although a reasonable assumption is that electrocardiographic QRS widening is a surrogate for delays in regional ventricular mechanical activation, a large volume of data has demonstrated that there is a subset of patients with widened QRS complex... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5063514 Fri, 22 Jul 2011 17:02:06 +0100 5063514 http://www.medworm.com/index.php?rid=5030269&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fnx85630041334711%2F Abstract  Renal dysfunction is often present and/or worsens in patients with heart failure and this is associated with increased costs of care, complications and mortality. The cardiorenal syndrome can be defined as the presence or development of renal dysfunction in patients with heart failure. Its mechanisms are likely related to low cardiac output, increased venous congestion and renal venous pressure, neurohormonal and inflammatory activation and local changes, such as adenosine release. Many drugs, including loop diuretics, may contribute to worsening renal function through the activation of some of these mechanisms. Renal damage is conventionally defined by the increase in creatinine and blood urea nitrogen blood levels. However, these changes may be not related with ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5030269 Tue, 12 Jul 2011 05:55:41 +0100 5030269 http://www.medworm.com/index.php?rid=5020368&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn4818p6082230845%2F This article discusses and compares how the activities of various proteases are involved in different cardiac abnormalities with respect to alterations in apoptotic pathways, cardiac remodeling, and cardiac dysfunction. An imbalance appears to occur between the activities of some proteases and their endogenous inhibitors in various types of hypertrophied and failing hearts, and this is likely to further accentuate subcellular remodeling and cardiac dysfunction. The importance of inhibiting the activities of both extracellular and intracellular proteases specific to distinct etiologies, in attenuating cardiac remodeling and apoptosis as well as biochemical changes of subcellular organelles, in heart failure has been emphasized. It is suggested that combination therapy to inhibit diff... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=5020368 Fri, 08 Jul 2011 06:33:22 +0100 5020368 http://www.medworm.com/index.php?rid=4993636&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyp2837vx36138148%2F Abstract  Remodeling of the myocardium and the extracellular matrix (ECM) occurs in heart failure irrespective of its initial cause. The ECM serves as a scaffold to provide structural support as well as housing a number of cytokines and growth factors. Hence, disruption of the ECM will result in structural instability as well as activation of a number of signaling pathways that could lead to fibrosis, hypertrophy, and apoptosis. The ECM is a dynamic entity that undergoes constant turnover, and the integrity of its network structure is maintained by a balance in the function of matrix metalloproteinases (MMPs) and their inhibitors, the tissue inhibitor of metalloproteinases (TIMPs). In heart disease, levels of MMPs and TIMPs are altered resulting in an imbalance between thes... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4993636 Wed, 29 Jun 2011 15:52:04 +0100 4993636 http://www.medworm.com/index.php?rid=4970155&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F34276lt2571846ku%2F Abstract  The renin-angiotensin-aldosterone-system (RAAS) plays a central role in the pathophysiology of heart failure and cardiorenal interaction. Drugs interfering in the RAAS form the pillars in treatment of heart failure and cardiorenal syndrome. Although RAAS inhibitors improve prognosis, heart failure–associated morbidity and mortality remain high, especially in the presence of kidney disease. The effect of RAAS blockade may be limited due to the loss of an inhibitory feedback of angiotensin II on renin production. The subsequent increase in prorenin and renin may activate several alternative pathways. These include the recently discovered (pro-) renin receptor, angiotensin II escape via chymase and cathepsin, and the formation of various angiotensin subforms upstre... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4970155 Wed, 22 Jun 2011 06:07:32 +0100 4970155 http://www.medworm.com/index.php?rid=4970154&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb734368892745tr5%2F In conclusion, prevention of renal dysfunction is possible in CHF, but treatment is still under investigation. New studies are necessary to establish whether a specific algorithm may be used to prevent renal dysfunction in CHF patients. Content Type Journal ArticlePages 1-8DOI 10.1007/s10741-011-9264-0Authors Daniela Dobre, INSERM, Center of Clinical Investigation - 9501, University Hospital Nancy, Lorrain Institute of Heart and Vessels Louis Mathieu, 4, rue du Morvan, 54500 Vandoeuvre-les-Nancy, FrancePatrick Rossignol, INSERM, Center of Clinical Investigation - 9501, University Hospital Nancy, Lorrain Institute of Heart and Vessels Louis Mathieu, 4, rue du Morvan, 54500 Vandoeuvre-les-Nancy, FranceMarco Metra, Institute of Cardiology, Department of Experimental and Applied Medic... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4970154 Wed, 22 Jun 2011 06:07:32 +0100 4970154 http://www.medworm.com/index.php?rid=4970157&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl72w7577470k5183%2F This article will mainly review recently published basic researches about the protective cardiovascular effects of resveratrol because these results may lead to the development of new clinical therapeutics in patients. Content Type Journal ArticlePages 1-12DOI 10.1007/s10741-011-9260-4Authors Hong Wang, Centre for Coronary Heart Disease, Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 BeiLiShi Rd, 100037 Xicheng District, Beijing, People’s Republic of ChinaYue-Jin Yang, Centre for Coronary Heart Disease, Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 BeiLiShi Rd, 100037 Xicheng District, ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4970157 Tue, 21 Jun 2011 18:01:17 +0100 4970157 http://www.medworm.com/index.php?rid=4970156&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F51077741l1426271%2F This article reviews common adverse drug effects and drug interactions associated with HF therapy in older patients and discusses strategies for reducing the risk of adverse drug events. In order to minimize these risks, it is essential that clinicians avoid prescribing unnecessary medications, adjust medication dosages to optimally balance benefits and side effects, and remain ever vigilant to the potential for medications to cause or contribute to clinically important adverse events and impaired quality of life. In treating older HF patients, the oft-cited dictum “start low, go slow” clearly applies. Despite the inherent challenges, with careful management and close follow-up, most older HF patients can be successfully treated through the judicious use of guideline-recommended... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4970156 Tue, 21 Jun 2011 18:01:17 +0100 4970156 http://www.medworm.com/index.php?rid=4970158&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F470r47478052xgg5%2F Abstract  Although inflammation is a physiologic response designed to protect us from infection, when unchecked and ongoing it may cause substantial harm. Both chronic heart failure (CHF) and chronic kidney disease (CKD) are known to cause elaboration of several pro-inflammatory mediators that can be detected at high concentrations in the tissues and blood stream. The biologic sources driving this chronic inflammatory state in CHF and CKD are not fully established. Traditional sources of inflammation include the heart and the kidneys which produce a wide range of pro-inflammatory cytokines in response to neurohormones and sympathetic activation. However, growing evidence suggests that non-traditional biomechanical mechanisms such as venous and tissue congestion due to volum... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4970158 Tue, 21 Jun 2011 18:01:16 +0100 4970158 http://www.medworm.com/index.php?rid=4913451&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx5j3449485575507%2F Abstract  Heart failure is a progressive illness that carries significant morbidity and mortality. This highly prevalent illness leads to frequent, costly hospitalizations with approximately 50% of patients being readmitted within 6 months of initial hospitalization. While rehospitalization has been extensively studied in the past, little progress has been made in terms of reducing readmission rates of heart failure patients in the last decade despite increasing costs with impending resource limitations. We discuss disease-centered, physician-centered, and patient-centered factors that lead to rehospitalization as well as community/resource availability factors that contribute to rehospitalization of patients suffering from chronic heart failure. In addition, predictors... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4913451 Sun, 05 Jun 2011 05:45:14 +0100 4913451 http://www.medworm.com/index.php?rid=4903981&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fcw53rm7w13211313%2F Abstract  A novel angiotensin-converting enzyme (ACE) homolog, named ACE2, is a monocarboxypeptidase which metabolizes several peptides. ACE2 degrades Angiotensin (Ang) II, a peptide with vasoconstrictive/proliferative effects, to generate Ang-(1-7), which acting through its receptor Mas exerts vasodilatory/anti-proliferative actions. In addition, as ACE2 is a multifunctional enzyme and its actions on other vasoactive peptides can also contribute to its vasoactive effects including the apelin-13 and apelin-17 peptides. The discovery of ACE2 corroborates the establishment of two counter-regulatory arms within the renin-angiotensin system. The first one is formed by the classical pathway involving the ACE-Ang II-AT1 receptor axis and the second arm is constituted by the ACE2-A... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4903981 Fri, 03 Jun 2011 06:00:45 +0100 4903981 http://www.medworm.com/index.php?rid=4903982&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb8j4474281gnt024%2F Abstract  Heart failure (HF) in the elderly is a major public health problem, and its prevalence is rising. Outcomes of HF in the elderly have not changed in the past 2 decades despite the introduction of novel HF therapies. This may be due to the combined impact of multiple comorbidities and frailty. The majority of elderly patients with HF are frail with multiple comorbidities. These comorbidities, along with frailty, contribute to the poor outcome of HF in the elderly and pose independent management challenges. More research is needed to better understand the interaction between frailty and multiple comorbidities and the mechanisms by which they impact HF and its management; develop prognostic tools that incorporate frailty and multiple comorbidities and provide more acc... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4903982 Tue, 31 May 2011 05:56:30 +0100 4903982 http://www.medworm.com/index.php?rid=4903983&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu143460x7362j858%2F Abstract  Diabetes mellitus is an important and prevalent risk factor for congestive heart failure. Diabetic cardiomyopathy has been defined as ventricular dysfunction that occurs in diabetic patients independent of a recognized cause such as coronary artery disease or hypertension. The disease course consists of a hidden subclinical period, during which cellular structural insults and abnormalities lead initially to diastolic dysfunction, later to systolic dysfunction, and eventually to heart failure. Left ventricular hypertrophy, metabolic abnormalities, extracellular matrix changes, small vessel disease, cardiac autonomic neuropathy, insulin resistance, oxidative stress, and apoptosis are the most important contributors to diabetic cardiomyopathy onset and progression. H... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4903983 Fri, 27 May 2011 18:14:57 +0100 4903983 http://www.medworm.com/index.php?rid=4903984&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb4327650m4q43525%2F Abstract  Renal function is the most important predictor of clinical outcome in heart failure (HF). It is therefore essential to have accurate and reliable measurement of renal function and early specific markers of renal impairment in patients with HF. Several renal functional entities exist, including glomerular filtration (GFR), glomerular permeability, tubulointerstitial damage, and endocrine function. Different markers have been studied that can be used to determine changes and the effect of treatment in these entities. In the present review, we summarize current and novel markers that give an assessment of renal function and prognosis in the setting of acute and chronic HF. Content Type Journal ArticlePages 1-10DOI 10.1007/s10741-011-9254-2Authors Kevin Damman, ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4903984 Sat, 21 May 2011 23:05:52 +0100 4903984 http://www.medworm.com/index.php?rid=4903985&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj3076123185383px%2F Abstract  The study tests the hypothesis that in patients admitted with acutely decompensated heart failure (ADHF), achievement of adequate body hydration status with intensive medical therapy, modulated by combined bioelectrical vectorial impedance analysis (BIVA) and B-type natriuretic peptide (BNP) measurement, may contribute to optimize the timing of patient’s discharge and to improve clinical outcomes. Three hundred patients admitted for ADHF underwent serial BIVA and BNP measurement. Therapy was titrated to reach a BNP value of <250 pg/ml, whenever possible. Patients were categorized as early responders (rapid BNP fall below 250 pg/ml); late responders (slow BNP fall below 250 pg/ml, after aggressive therapy); and non-responders (BNP persistently &... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4903985 Sat, 21 May 2011 23:05:51 +0100 4903985 http://www.medworm.com/index.php?rid=4842754&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F40414545155j3q27%2F This article covers a huge gap in the existing literature regarding the pathophysiology of post-resuscitation period and provides a better understanding of the pathophysiology and pathogenesis of post-resuscitation myocardial stunning. Content Type Journal ArticlePages 1-12DOI 10.1007/s10741-011-9255-1Authors Athanasios Chalkias, Department of Anatomy, Medical School, University of Athens, 75 Mikras Asias street, 11527 Athens, GreeceTheodoros Xanthos, Department of Anatomy, Medical School, University of Athens, 75 Mikras Asias street, 11527 Athens, Greece Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4842754 Mon, 16 May 2011 15:47:08 +0100 4842754 http://www.medworm.com/index.php?rid=4831078&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw116n8185h23x841%2F Abstract  Physical activity is recommended for people with stable heart failure (HF), because it is known to improve quality of life and health outcomes. However, adherence to this recommendation has been poor in many studies. A systematic review was conducted to examine the effectiveness of strategies used to promote exercise adherence in those with HF. The following databases were searched for relevant literature published between January 1980 and December 2010: British Nursing Index; CINAHL; Cochrane Library; Embase; Medline and PsycINFO. Papers with a control group focused on adults with HF that measured exercise or physical activity adherence were included. Nine randomised controlled trials were identified, involving a total of 3,231 patients (range 16–2,331). Six of... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4831078 Thu, 12 May 2011 16:45:30 +0100 4831078 http://www.medworm.com/index.php?rid=4821799&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj73018884181vj13%2F Abstract  In the United States and Europe, approximately 90% of heart failure hospitalizations are due to symptoms and signs of sodium and fluid excess. Congestion is associated with heart failure progression. Venous congestion, rather than a reduced cardiac output, may be the primary hemodynamic factor driving worsening renal function in patients with acutely decompensated heart failure. According to data from large national registries, approximately 40% of hospitalized heart failure patients are discharged with unresolved congestion, which may contribute to unacceptably high re-hospitalization rates. Diuretics reduce the symptoms and signs of fluid overload, but their effectiveness can be reduced by excess salt intake, underlying chronic kidney disease, renal adaptation t... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4821799 Wed, 11 May 2011 06:24:23 +0100 4821799 http://www.medworm.com/index.php?rid=4821800&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F750t32p15u5t18tn%2F Abstract  Most patients with heart failure (HF) already have or develop renal dysfunction; this might contribute to their poor outcome. Current treatment for HF can also contribute to worsen renal function. High furosemide doses are traditionally associated with worsening renal function (WRF), but patients with fluid overload may benefit of aggressive fluid removal. Unfortunately, promising therapies like vasopressin antagonists and adenosine antagonists have not been demonstrated to improve outcomes. Likewise, correction of low renal blood flow through dopamine, inotropic agents, or vasodilators does not seem to be associated with a clear benefit. However, transient WRF associated with acute HF treatment may not necessarily portend a poor prognosis. In this review, we focu... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4821800 Tue, 10 May 2011 06:06:13 +0100 4821800 http://www.medworm.com/index.php?rid=4821801&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm3k865002k16040r%2F Content Type Journal ArticlePages 1-1DOI 10.1007/s10741-011-9251-5Authors Dinna N. Cruz, Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, ItalyMihai Gheorghiade, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USAAlberto Palazzuoli, Department of Internal Medicine and Metabolic Disease, Cardiology Section, University of Siena, Siena, ItalyClaudio Ronco, Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, ItalySean M. Bagshaw, Division of Critical Care Medicine, University of Alberta Hospital, 3C1.12 Walter C. Mackenzie Centre, 8440-122 Street, Edmonton, AB T6G2B7, Canada Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Re... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4821801 Tue, 10 May 2011 06:06:12 +0100 4821801 http://www.medworm.com/index.php?rid=4805749&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft00g9753338302m8%2F Abstract  Heart and kidney interactions are fascinating, in the sense that failure of the one organ strongly affects the function of the other. In this review paper, we analyze how principal driving forces for glomerular filtration and renal blood flow are changed in heart failure. Moreover, renal autoregulation and modulation of neurohumoral factors, which can both have repercussions on renal function, are analyzed. Two paradigms seem to apply. One is that the renin-angiotensin system (RAS), the sympathetic nervous system (SNS), and extracellular volume control are the three main determinants of renal function in heart failure. The other is that the classical paradigm to analyze renal dysfunction that is widely applied in nephrology also applies to the pathophysiology of h... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4805749 Sat, 07 May 2011 15:43:24 +0100 4805749 http://www.medworm.com/index.php?rid=4782298&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F46t4kq51j1j3970r%2F Abstract  Cardiac resynchronization therapy reduces mortality and morbidity in heart failure patients with wide QRS and severe impairment of left ventricular systolic function, who are symptomatic despite optimal medical therapy. However, a high percentage of patients fail to show clinical or echocardiographic response to this treatment. Beyond current selection criteria, other elements, such as QRS duration and morphology, concomitant medical therapy, degree of right ventricle dysfunction, myocardial viability, presence of left ventricular dyssynchrony, and associated renal dysfunction, play a crucial role in modulating the response to cardiac resynchronization. Consequently, they should be part of the standard pre-implant evaluation, as they could be used to identify pati... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4782298 Sun, 01 May 2011 15:32:30 +0100 4782298 http://www.medworm.com/index.php?rid=4771850&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fqmw85516246142g7%2F Abstract  The aim of this review is to analyze in detail some possible pathophysiological mechanisms linking obesity and cardiac endocrine function, in order to try to explain the negative association previously observed between BMI and BNP values in both healthy subjects and patients with cardiovascular diseases. In particular, we discuss the hypothesis that the response of the cardiac endocrine system is the integrated resultant of several and contrasting physiological and pathological interactions, including the effects of peptide and steroid hormones, cytokines, cardiovascular hemodynamics, clinical conditions, and pharmacological treatment. Several studies suggested that gonadal function regulates both body fat distribution and cardiac endocrine function. Visceral fat ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4771850 Tue, 26 Apr 2011 20:57:12 +0100 4771850 http://www.medworm.com/index.php?rid=4771851&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl77l755636172782%2F Content Type Journal ArticlePages 1-3DOI 10.1007/s10741-011-9247-1Authors Norman C. Wang, Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USAGregg C. Fonarow, Ahmanson-UCLA Cardiomyopathy Center, Los Angeles, CA, USAMihai Gheorghiade, Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, 645 North Michigan Avenue, Suite 1006, Chicago, IL 60611, USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4771851 Mon, 25 Apr 2011 16:41:27 +0100 4771851 http://www.medworm.com/index.php?rid=4754895&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa158p430485631g8%2F Abstract  Congestion is a major component of the clinical syndrome of heart failure, and diuretic therapy remains the cornerstone of congestion management. Despite being widely used, there is very limited evidence from prospective randomized studies to guide the prescription and titration of diuretics. A thorough understanding of the pharmacology of loop diuretics is crucial to the optimal use of these agents. Although multiple observational studies have suggested that high doses of diuretics may be harmful, all such analyses are confounded by the association of higher diuretic doses with greater severity of illness and comorbidity. Recent data from randomized trials suggest that higher doses of diuretics may be more effective at relieving congestion and that associated cha... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4754895 Fri, 22 Apr 2011 16:02:22 +0100 4754895 http://www.medworm.com/index.php?rid=4671495&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdu23v35250h33lr0%2F Abstract  We review the pharmacologic, interventional and device programming treatment options for patients with implantable cardioverter-defibrillators who present with acute heart failure and implantable cardioverter-defibrillator shocks. Content Type Journal ArticlePages 1-8DOI 10.1007/s10741-011-9241-7Authors Jason Bradfield, UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, A2-237 CHS, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1679, USARoderick Tung, UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, A2-237 CHS, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1679, USANoel G. Boyle, UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4671495 Wed, 30 Mar 2011 23:54:41 +0100 4671495 http://www.medworm.com/index.php?rid=4644104&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd51j13r1j4h1445m%2F Abstract  In this review, the physiological rationale for atrioventricular and interventricular delay optimization of cardiac resynchronization therapy is discussed including the influence of exercise and long-term cardiac resynchronization therapy. The broad spectrum of both invasive and non-invasive optimization methods is reviewed with critical appraisal of the literature. Although the spectrum of both invasive and non-invasive optimization methods is broad, no single method can be recommend for standard practice as large-scale studies using hard endpoints are lacking. Current efforts mainly investigate optimization during resting conditions; however, there is a need to develop automated algorithms to implement dynamic optimization in order to adapt to physiological alte... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4644104 Wed, 23 Mar 2011 16:57:28 +0100 4644104 http://www.medworm.com/index.php?rid=4637005&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fcnv9k5554mn66362%2F Abstract  Cardiac resynchronization therapy (CRT) has been demonstrated to improve mortality and morbidity in patients with chronic, stable heart failure who have reduced left ventricular ejection fraction and prolonged QRS duration. Patients with acute heart failure syndromes (AHFS) have been excluded from major CRT trials. The potential benefits and risks of implementation of these devices in the AHFS setting are largely unknown. In this review, we discuss the role that early implementation of CRT may have in improving postdischarge outcomes. In addition, we also discuss the potential adverse consequences of inserting these devices in patients who are in the tenuous clinical state of AHFS. Content Type Journal ArticlePages 1-10DOI 10.1007/s10741-011-9237-3Authors No... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4637005 Tue, 22 Mar 2011 18:11:03 +0100 4637005 http://www.medworm.com/index.php?rid=4637004&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5x66717412745071%2F In conclusion, CysC appears to be an interesting marker of renal function and is useful for risk stratification in heart failure. Content Type Journal ArticlePages 1-11DOI 10.1007/s10741-011-9242-6Authors Johan Lassus, Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, FinlandVeli-Pekka Harjola, Division of Emergency Care, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4637004 Tue, 22 Mar 2011 18:11:03 +0100 4637004 http://www.medworm.com/index.php?rid=4632269&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh156722716884244%2F This article reviews the technique, complications, outcome data, and alternatives to this management strategy. The potential role of this therapeutic modality in those hospitalized with acute heart failure syndromes is discussed. Content Type Journal ArticlePages 1-9DOI 10.1007/s10741-011-9238-2Authors Jason C. Rubenstein, Department of Medicine, Division of Cardiovascular Medicine, Froedtert East Clinics, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USAJames A. Roth, Department of Medicine, Division of Cardiovascular Medicine, Froedtert East Clinics, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4632269 Mon, 21 Mar 2011 19:00:22 +0100 4632269 http://www.medworm.com/index.php?rid=4632270&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1w12l10861v4g144%2F Abstract  Implantable cardioverter-defibrillators have proven efficacy in reducing mortality in patients with reduced left ventricular ejection fraction in both the primary and the secondary prevention settings. All randomized trials demonstrating this benefit have been conducted in outpatients with stable heart failure symptoms. Whether implantable cardioverter-defibrillators confer a benefit when implemented in patients with chronically reduced left ventricular ejection fraction in the acute heart failure setting is unknown. The purpose of this document is to review the existing literature related to this subject. Content Type Journal ArticlePages 1-4DOI 10.1007/s10741-011-9243-5Authors Norman C. Wang, Cardiovascular Institute, University of Pittsburgh Medical Center... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4632270 Mon, 21 Mar 2011 19:00:20 +0100 4632270 http://www.medworm.com/index.php?rid=4623134&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx1kr270274k53g11%2F Abstract  Acute heart failure syndromes (AHFS) represent the most common discharge diagnoses in adults over age 65 and translate into dramatically increased heart failure–associated morbidity and mortality. Conventional approaches to the early detection of pulmonary and systemic congestion have been shown to be of limited sensitivity. Despite their proven efficacy, disease management and structured telephone support programs have failed to achieve widespread use in part due to their resource intensiveness and reliance upon motivated patients. While once thought to hold great promise, results from recent prospective studies on telemonitoring strategies have proven disappointing. Implantable devices with their capacity to monitor electrophysiologic and hemodynamic parameter... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4623134 Sat, 19 Mar 2011 02:54:01 +0100 4623134 http://www.medworm.com/index.php?rid=4611460&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fmw063236214275n5%2F Abstract  Heart rhythm problems are common among patients who are hospitalized with acute heart failure (HF). Although it is often difficult to determine whether a tachyarrhythmia is the major contributor to an acute HF decompensation or merely a consequence of the decompensation, both issues usually need to be addressed. There is also a subset of patients with HF who have a tachycardia-induced cardiomyopathy (TIC), where the sole cause of the ventricular dysfunction is the heart rhythm problem. In most cases, the management of a tachyarrhythmia in a patient with acute HF is not significantly different than the management of a heart rhythm problem in any patient, but there are several special clinical scenarios and important considerations. These considerations include the ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4611460 Tue, 15 Mar 2011 17:24:20 +0100 4611460 http://www.medworm.com/index.php?rid=4594127&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff1683611w8425725%2F Abstract  Post-cardiac surgery acute kidney injury (AKI) is common and is associated with a significant increase in morbidity and mortality. We aimed to systematically review randomised trials that assessed the renoprotective utility of pharmacological agents in patients undergoing cardiac surgery. We searched PubMed, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials comparing renoprotective pharmacological interventions with control in adult patients undergoing cardiac surgery with cardiopulmonary bypass. We extracted data for mortality, need for renal replacement therapy (RRT), incidence of AKI, and creatinine clearance at 24–48 h. About 49 randomised controlled trials involving 4605 patients were included. Pharmacologic... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4594127 Sat, 12 Mar 2011 16:53:12 +0100 4594127 http://www.medworm.com/index.php?rid=4594128&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx72743181n438454%2F Abstract  In the past decade, cardiac pacing devices (either permanent pacemakers or Implanted Cardioverter Defibrillators) have become increasingly common in patients with heart failure. The manner in which the device is programmed to pace the heart can have significant implications on cardiac hemodynamics, both positive and negative. As such, in patients hospitalized with acute heart failure who have cardiac pacing devices, the clinician should note whether the programming of the device could be contributing to the patient’s symptoms, and whether further programming changes could be made to improve the patient’s clinical status. As of this date, there are no consensus guidelines available for the management of pacemaker programming in acute heart failure. This review ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4594128 Sat, 12 Mar 2011 16:53:11 +0100 4594128 http://www.medworm.com/index.php?rid=4594129&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F68u122455731n771%2F Abstract  Resveratrol, a polyphenol phytoalexin, present in red wine and grapes possesses diverse biochemical and physiological properties, including estrogenic, antiplatelet, and anti-inflammatory properties as well as a wide range of health benefits ranging from chemoprevention to cardioprotection. Recently, several studies described resveratrol as an anti-aging compound. This review focuses on the anti-aging aspects of resveratrol, the possible mechanisms of action, and emerging controversy on its life-prolonging ability. It appears that resveratrol can induce the expression of several longevity genes including Sirt1, Sirt3, Sirt4, FoxO1, Foxo3a and PBEF and prevent aging-related decline in cardiovascular function including cholesterol level and inflammatory response, but ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4594129 Sat, 12 Mar 2011 07:01:27 +0100 4594129 http://www.medworm.com/index.php?rid=4550230&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh0037565h374x703%2F Abstract  The association between cardiac failure and renal function impairment has gained wide recognition over the last decade. Both structural damage in the form of systemic atherosclerosis and (patho) physiological hemodynamic changes may explain this association. As regards hemodynamic factors, renal impairment in chronic heart failure is traditionally assumed to be mainly due to a decrease in cardiac output and a subsequent decrease in renal perfusion. This will lead to a decrease in glomerular filtration rate and a compensatory increase in tubular sodium retention. The latter is a physiological renal response aimed at retaining fluids in order to increase cardiac filling pressure and thus renal perfusion. In heart failure, however, larger increases in cardiac filling... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4550230 Wed, 02 Mar 2011 06:59:22 +0100 4550230 http://www.medworm.com/index.php?rid=4502681&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F841641775h8532n4%2F Abstract  Anemia is a disease that is often associated with heart failure (HF) and renal insufficiency (RI). This unfavorable triad of conditions has been called Cardio-Renal-Anemia Syndrome (CRS). The association of HF, RI, and anemia is poorly reported in multicenter clinical trials, so the pathophysiologic mechanisms and treatment options need to be better defined. When CRS patients develop anemia, a “perfect storm” often occurs: HF and RI cause anemia which will worsen the first two conditions. Anemia appears to be the result of complex interactions between cardiac performance, bone marrow homeostasis, renal dysfunction, and various drug side effects. However, neurohormonal and inflammatory activities play a key role in the beginning and progression of the disease. ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4502681 Fri, 18 Feb 2011 17:23:39 +0100 4502681 http://www.medworm.com/index.php?rid=4495954&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4j517p5223251157%2F Abstract  Over the last decade, it has become increasingly clear that the cardiovascular and renal systems are interdependent. Primary disorders of either system have been shown to disturb the other system. As a result, a class of cardiorenal syndromes (CRS) has been identified wherein a vicious cycle is established as an acute/chronic dysfunction of either the kidney or the heart exacerbates the loss of function in the other organ. Progressive loss of kidney function observed in patients with CRS (mostly types 2 and 4) leads to reduced production of calcitriol (active vitamin D) and an imbalance in calcium and phosphorus levels, which are correlated with increased rates of cardiovascular events and mortality. In addition, hypocalcemia can lead to prolonged and excessive se... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4495954 Wed, 16 Feb 2011 06:56:17 +0100 4495954 http://www.medworm.com/index.php?rid=4460803&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl65272x143627760%2F Abstract  The pathophysiology of acute heart failure syndromes (AHFS), defined as a change or worsening in heart failure symptoms and signs, is complex. The variety of adverse neurohormonal adaptations includes increased levels of plasma renin, aldosterone and angiotensin II, all responsible for cardio-renal dysfunction. In fact, such alterations result in an array of clinical changes that include abnormal haemodynamics, altered ventricular filling pressures, pathological neurohormonal responses, leading to fluid overload, congestion and ultimately heart failure symptoms. Clinical pictures can be various: in spite of a usual improvement in dyspnoea, little weight change and significant morbidity are generally observed during hospitalization. Short-term outcomes are characte... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4460803 Mon, 07 Feb 2011 22:57:57 +0100 4460803 http://www.medworm.com/index.php?rid=4442701&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9pmh726876332432%2F Abstract  “Cardio-Renal Syndromes” (CRS) are disorders of the heart and kidneys in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The pathophysiology of CRS is complex, and there is accumulating evidence that various novel biomarkers are useful for diagnosis, prognostication, and risk stratification in patients with heart failure and chronic kidney disease (CRS). When both the heart failure (HF) and CKD occur together, it is important to have biomarkers that are able to risk stratify patients by looking at both their heart and kidney aspects. There are some promising newer renal biomarkers that may contribute to a better evaluation and prediction of prognosis in CRS patients. Most of the renal biomarkers studies in ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4442701 Fri, 04 Feb 2011 17:48:23 +0100 4442701 http://www.medworm.com/index.php?rid=4442702&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr042v4p6v5uj7r76%2F Abstract  Chronic heart failure (CHF) is characterized by decreased nitric oxide (NO) bioavailability. In addition, the beneficial NO turns to be deleterious when it reacts with superoxide anion, leading to peroxynitrite formation. Numerous experimental and clinical studies have reported increased production of reactive oxygen species (superoxide, hydrogen peroxide, hydroxyl radical) both in animals and patients with CHF. Moreover, there are indicative data suggesting mechanisms associated with endothelial dysfunction in states of CHF, mainly attributed to decreased NO bioavailability and enhanced inactivation of the latter. Thus, such molecules appear to be potential targets in patients with CHF. These patients are strong candidates to receive a variety of therapeutic agen... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4442702 Fri, 04 Feb 2011 03:35:25 +0100 4442702 http://www.medworm.com/index.php?rid=4415401&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk1hp1672l8344175%2F Content Type Journal ArticlePages 1-1DOI 10.1007/s10741-011-9227-5Authors Frits W. Prinzen, Departments of Physiology, Cardiology and Biomedical Engineering, Cardiovascular Research Institute Maastricht, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The NetherlandsKevin Vernooy, Departments of Physiology, Cardiology and Biomedical Engineering, Cardiovascular Research Institute Maastricht, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The NetherlandsBart W. L. De Boeck, University Hospital Basel, Basel, SwitzerlandTammo Delhaas, Departments of Physiology, Cardiology and Biomedical Engineering, Cardiovascular Research Institute Maastricht, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands Journal Heart Failure ReviewsOnline ISSN 1573-73... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4415401 Thu, 27 Jan 2011 10:02:33 +0100 4415401 http://www.medworm.com/index.php?rid=4400798&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7104827822651607%2F Abstract  “Cardio-renal syndromes” (CRS) are disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The current definition has been expanded into five subtypes whose etymology reflects the primary and secondary pathology, the time-frame and simultaneous cardiac and renal co-dysfunction secondary to systemic disease: CRS type I: acute worsening of heart function (AHF-ACS) leading to kidney injury and/or dysfunction. CRS type II: chronic abnormalities in heart function (CHF-CHD) leading to kidney injury or dysfunction. CRS type III: acute worsening of kidney function (AKI) leading to heart injury and/or dysfunction. CRS type IV: chronic kidney disease (CKD) leading to heart injury, disease... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4400798 Sat, 22 Jan 2011 20:14:33 +0100 4400798 http://www.medworm.com/index.php?rid=4400799&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx542680812410519%2F Abstract  The prevalence of heart failure (HF) is increasing. A distinction is made between diastolic HF (preserved left ventricular ejection fraction (LVEF)) and systolic HF (reduced LVEF). Advanced glycation end-products (AGEs) are crystallized proteins that accumulate during ageing, but are particularly increased in patients with diabetes mellitus and in patients with renal failure. Through the formation of collagen crosslinks, and by interaction with the AGE-receptor, which impairs calcium handling and increases fibrosis, AGE-accumulation has pathophysiologically been associated with the development of diastolic and renal dysfunction. Interestingly, diastolic dysfunction is a frequent finding in elderly patients, diabetic patients and in patients with renal failure. Tak... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4400799 Sat, 22 Jan 2011 20:14:32 +0100 4400799 http://www.medworm.com/index.php?rid=4322937&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc33g37411855m28u%2F Abstract  Cardiac resynchronization therapy (CRT) has revolutionized the treatment of selected patients with systolic heart failure. It is well recognized, however, that the symptomatic response to and the outcome of CRT is highly variable. The degree of pre-implant mechanical dyssynchrony and the extent as well as the localization of myocardial scarring are known to contribute to this variability. Cardiovascular magnetic resonance (CMR) is the gold-standard imaging modality for the assessment of myocardial structure and function. Recently, CMR has also been shown to be useful in assessing cardiac dyssynchrony and in guiding left ventricular lead deployment away from scarred myocardium. This review explores the current role of CMR in risk stratification and in guiding LV le... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4322937 Wed, 05 Jan 2011 16:51:10 +0100 4322937 http://www.medworm.com/index.php?rid=4303211&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdx74383345755160%2F Abstract  The “Cardio-Renal Syndrome” (CRS) is a disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The general definition has been expanded to five subtypes reflecting the primacy of organ dysfunction and the time-frame of the syndrome: CRS type I: acute worsening of heart function (AHF-ACS) leading to kidney injury and/or dysfunction. CRS type II: chronic abnormalities in heart function (CHF-CHD) leading to kidney injury or dysfunction. CRS type III: acute worsening of kidney function (AKI) leading to heart injury and/or dysfunction. CRS type IV: chronic kidney disease (CKD) leading to heart injury, disease and/or dysfunction. CRS type V: systemic conditions leading to simultaneous i... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4303211 Fri, 31 Dec 2010 18:03:12 +0100 4303211 http://www.medworm.com/index.php?rid=4302377&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3787q2863r05700h%2F Abstract  Cardiac and kidney disease are common, increasingly encountered and often co-exist. Recently, the Acute Dialysis Quality Initiative (ADQI) Working Group convened a consensus conference to develop a classification scheme for the CRS and for five discrete subtypes. These CRS subtypes likely share pathophysiologic mechanisms, however, also have distinguishing clinical features, in terms of precipitating events, risk identification, natural history and outcomes. Knowledge of the epidemiology of heart–kidney interaction stratified by the proposed CRS subtypes is increasingly important for understanding the overall burden of disease for each CRS subtype, along with associated morbidity, mortality and health resource utilization. Likewise, an understanding of the epide... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4302377 Thu, 30 Dec 2010 18:04:34 +0100 4302377 http://www.medworm.com/index.php?rid=4300996&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9r57p681ht228937%2F Content Type Journal ArticleDOI 10.1007/s10741-010-9222-2Authors Paul J. Hauptman, Department of Medicine, Saint Louis University School of Medicine, St. Louis, MO USADouglas L. Mann, Department of Medicine, Washington University School of Medicine, St. Louis, MO USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4300996 Wed, 29 Dec 2010 17:12:19 +0100 4300996 http://www.medworm.com/index.php?rid=4289147&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv281747q680x0060%2F Abstract  Left ventricular lead position is one of the main determinants of CRT response. There are several approaches in LV lead positioning that include favoring an optimal anatomical position or targeting either the segment with maximal mechanical dyssynchrony or a region with maximal electrical delay. The conventional LV lead implantation faces several technical difficulties that may prevent the obtaining of a stable position and good performance of the LV lead without phrenic nerve stimulation. In addition, implant of the LV pacing lead in areas with myocardial scar may result in less than optimal cardiac resynchronization. Several strategies have been proposed to overcome all these obstacles including multimodality cardiac imaging to help in preprocedural or intraproc... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4289147 Thu, 23 Dec 2010 17:49:55 +0100 4289147 http://www.medworm.com/index.php?rid=4272817&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu085vpkrt0242340%2F Abstract  Cardiovascular magnetic resonance imaging (CMR) plays an increasing role in the assessment of patients with various cardiovascular disorders. Given its enhanced spatial resolution, improved tissue characterization, and lack of ionizing radiation, it has become the test of choice in the evaluation of patients with new-onset cardiomyopathy of unknown etiology. In this paper, we will review the role of CMR in the evaluation of patients with various types of non-ischemic cardiomyopathy. Content Type Journal ArticleDOI 10.1007/s10741-010-9221-3Authors Mouaz H. Al-Mallah, King Abdul-Aziz Cardiac Center, King Abdul-Aziz Medical City, Department Mail Code 1413, P.O. Box 22490, Riyadh, 11426 Kingdom of Saudi ArabiaMohammad Naseem Shareef, King Abdul-Aziz Cardiac Center... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4272817 Fri, 17 Dec 2010 17:40:44 +0100 4272817 http://www.medworm.com/index.php?rid=4272818&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F03tx4500867gj781%2F Abstract  Chronic heart failure (CHF) is a major and growing problem in the western hemisphere, affecting about 5 million patients in the United States. In daily practice patients with left ventricular systolic dysfunction (LVSD) and significant angiographic coronary artery disease (CAD) are felt to have an ischemic cardiomyopathy (ICMP) and those without CAD or mild–moderate CAD out of proportion to the extent of LVSD are felt to have a non-ischemic cardiomyopathy (NICMP). Although invasive coronary angiography is the gold standard for the diagnosis of CAD, recent advances in non-invasive imaging have created multiple options for evaluating ICMP and NICMP. This review details the role of cardiac imaging in the diagnosis of ICMP and NICMP and outlines an algorithm of... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4272818 Fri, 17 Dec 2010 06:52:41 +0100 4272818 http://www.medworm.com/index.php?rid=4272819&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ffpq0k5n56q768349%2F Abstract  Vagus nerve stimulation was performed experimentally for the first time more than 150 years ago. In the 1980s and 1990s, vagus nerve stimulation was shown, both in the anesthetized and in the conscious animal, to exert marked antiarrhythmic effects, particularly during acute myocardial ischemia. There is a strong rationale for a beneficial effect of augmented vagal activity in the setting of chronic heart failure. Studies in experimental models of heart failure showed that chronic vagus nerve stimulation exerts beneficial effects on left ventricular function and on survival. Vagus nerve stimulation is approved in man for refractory epilepsy and depression. The first-in-man study performed in 32 patients with chronic heart failure suggests that vagus nerve sti... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4272819 Fri, 17 Dec 2010 06:52:39 +0100 4272819 http://www.medworm.com/index.php?rid=4272820&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx41382k3t6820480%2F Abstract  Chagas’ disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America. Nearly 30% of infected patients develop life-threatening complications, and with a latency of 10–30 years, mostly Chagas’ heart disease which is currently the major cause of morbidity and mortality in Latin America, enormously burdening economic resources and dramatically affecting patients’ social and labor situations. Because of increasing migration, international tourism and parasite transfer by blood contact, intrauterine transfer and organ transplantation, Chagas’ heart disease could potentially become a worldwide problem. To raise awareness of this problem, we reflect on the epidemiology and etiopathology of Chagas’ diseas... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4272820 Fri, 17 Dec 2010 06:52:38 +0100 4272820 http://www.medworm.com/index.php?rid=4272821&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2461176wt1268g07%2F Abstract  The evaluation of ischemic heart disease is the cornerstone of clinical Cardiology. Although there are many means of ischemic evaluation, all are with their own limitations. While perfusion-based studies are highly sensitive, they lack specificity. Conversely, systolic wall motion analysis with echocardiography tends to have high specificity; however, the sensitivity may be limited by short duration of systolic abnormalities when present. With the advent of Doppler echocardiography, and more specifically tissue Doppler imaging, and strain and strain rate imaging, a more comprehensive evaluation of the left ventricular function is available, including diastole. Diastolic abnormalities in the setting of ischemia are now being studied using these new parameters and h... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4272821 Thu, 16 Dec 2010 06:53:54 +0100 4272821 http://www.medworm.com/index.php?rid=4267298&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv42056h467x35157%2F Abstract  The evaluation of left ventricular systolic function is one of the most common reasons for referral for a non-invasive cardiac imaging study. In addition to its diagnostic and prognostic value, an assessment of ejection fraction can also be used to guide medical and device therapy. Thus, obtaining an accurate and reproducible assessment of LVEF is essential for patient management. This review will focus on novel multi-modality techniques used for the quantification of left ventricular systolic function. Emerging echocardiography techniques such as three-dimensional echocardiography and strain imaging and their incremental role over traditional 2D imaging will be discussed. In addition, new developments expanding nuclear imaging techniques’ evaluation of left ven... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4267298 Tue, 14 Dec 2010 06:41:09 +0100 4267298 http://www.medworm.com/index.php?rid=4249632&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff11t3611160r10tr%2F This article will review the principal echocardiographic methods of dyssynchrony analysis by tissue Doppler imaging, (opposing wall delay, 12-site standard deviation or Yu index, and longitudinal strain), routine pulsed-Doppler (interventricular mechanical delay, pre-ejection delay and filling time ratio), and speckle tracking (including radial, circumferential, and longitudinal strain). In addition, dyssynchrony analysis by cardiac magnetic resonance imaging is introduced as a potential alternative technique. The technical features, strengths and limitations, and clinical evidence for these methods are discussed, including a practical clinical approach. Content Type Journal ArticlePages 1-14DOI 10.1007/s10741-010-9220-4Authors Olusegun A. Oyenuga, University of Pittsburgh, Sca... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4249632 Wed, 08 Dec 2010 18:13:25 +0100 4249632 http://www.medworm.com/index.php?rid=4242513&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff32x616755454100%2F Abstract  Cardio-renal syndrome (CRS) is a renal dysfunction occurring in a large percentage of patients hospitalized with congestive heart failure (HF). Cardiac and renal dysfunctions often occur simultaneously because they share causes and pathogenetic mechanisms. Current therapies for HF are focused on improving myocardial function and hemodynamic balance, but may have potential consequences for worsening renal function. The lack of specific trials in this field highlights the need for further studies aimed to assess efficacy and safety, titration and appropriate dosages of drugs, according to the etiology and severity of both myocardial and renal dysfunction. Moreover, the most recent clinical trials evaluating new drugs on clinical and renal outcome in acute heart fail... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4242513 Mon, 06 Dec 2010 18:47:38 +0100 4242513 http://www.medworm.com/index.php?rid=4242514&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx0w24n2jw66317x8%2F Abstract  Cardiac resynchronization therapy is a key non-pharmacological treatment strategy for drug-refractory moderate-to-severe symptomatic heart failure in the presence of compromised left ventricular function and ventricular conduction delay. Because not all patients with conventional criteria benefit from CRT, continuous efforts have been directed toward improving patient selection; in particular, emerging echocardiographic criteria such as regional and global myocardial strains are being investigated to better predict CRT response. In the meantime, growing evidence from large randomized controlled trials (RCTs, REVERSE, and MADIT-CRT) has demonstrated that even mildly symptomatic patients may benefit from CRT. The role of CRT in heart failure patients with narrow QRS... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4242514 Mon, 06 Dec 2010 15:07:38 +0100 4242514 http://www.medworm.com/index.php?rid=4230829&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2445451042065784%2F Abstract  Chronic heart failure (HF) is associated with autonomic dysregulation characterized by a sustained increase in sympathetic drive and by withdrawal of parasympathetic activity. Sympathetic overdrive and increased heart rate are predictors of poor long-term outcome in patients with HF. Considerable evidence exists that supports the use of pharmacologic agents that partially inhibit sympathetic activity as effective long-term therapy for patients with HF; the classic example is the wide use of selective and non-selective beta-adrenergic receptor blockers. In contrast, modulation of parasympathetic activation as potential therapy for HF has received only limited attention over the years given its complex cardiovascular effects. In this article, we review the results o... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4230829 Thu, 02 Dec 2010 18:14:34 +0100 4230829 http://www.medworm.com/index.php?rid=4225904&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2g22660792115323%2F Abstract  Left ventricular hypertrophy (LVH) is a cardiovascular complication highly prevalent in patients with chronic kidney disease (CKD) and end-stage renal disease. LVH in CKD patients has generally a negative prognostic value, because it represents an independent risk factor for the development of arrhythmias, sudden death, heart failure and ischemic heart disease. LVH in CKD patients is secondary to both pressure and volume overload. Pressure overload is secondary to preexisting hypertension, but also to a loss of elasticity of the vessels and to vascular calcifications, leading to augmented pulse pressure. Anemia and the retention of sodium and water secondary to decreased renal function are responsible for volume overload, determining a hyperdynamic state. In parti... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4225904 Tue, 30 Nov 2010 07:04:28 +0100 4225904 http://www.medworm.com/index.php?rid=4225903&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa67q925153216017%2F Abstract  In this paper, two different aspects of the relationship between chronic kidney disease and sudden cardiac death (SCD) have been reviewed. In end-stage renal disease patients, SCD risk is increased, and among patients implanted with a cardioverter defibrillator (ICD), dialysed ones carry a superior relative risk compared to non-dialysed ones. Cardiorenal syndrome patients have increase in SCD risk, and when receiving ICD implantation, survival improves. Content Type Journal ArticleDOI 10.1007/s10741-010-9210-6Authors Luigi Padeletti, Istituto di Clinica Medica e Cardiologia, Università degli Studi di Firenze, AUO Careggi, Viale Morgagni 85, 50134 Florence, ItalyLisa Innocenti, Istituto di Clinica Medica e Cardiologia, Università degli Studi di Firenze, AUO C... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4225903 Tue, 30 Nov 2010 07:04:28 +0100 4225903 http://www.medworm.com/index.php?rid=4206531&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Flhmn33747rhq0202%2F Abstract  Impact of variability in the measured parameter is rarely considered in designing clinical protocols for optimization of atrioventricular (AV) or interventricular (VV) delay of cardiac resynchronization therapy (CRT). In this article, we approach this question quantitatively using mathematical simulation in which the true optimum is known and examine practical implications using some real measurements. We calculated the performance of any optimization process that selects the pacing setting which maximizes an underlying signal, such as flow or pressure, in the presence of overlying random variability (noise). If signal and noise are of equal size, for a 5-choice optimization (60, 100, 140, 180, 220 ms), replicate AV delay optima are rarely identical but rather... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4206531 Thu, 25 Nov 2010 20:09:01 +0100 4206531 http://www.medworm.com/index.php?rid=4203742&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff531jm7ku1w19265%2F Abstract  In children with congenital or acquired complete atrioventricular (AV) block, ventricular pacing is indicated to increase heart rate. Ventricular pacing is highly beneficial in these patients, but an important side effect is that it induces abnormal electrical activation patterns. Traditionally, ventricular pacemaker leads are positioned at the right ventricle (RV). The dyssynchronous pattern of ventricular activation due to RV pacing is associated with an acute and chronic impairment of left ventricular (LV) function, structural remodeling of the LV, and increased risk of heart failure. Since the degree of pacing-induced dyssynchrony varies between the different pacing sites, ‘optimal-site pacing’ should aim at the prevention of mechanical dyssynchrony. Espec... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4203742 Tue, 23 Nov 2010 18:15:22 +0100 4203742 http://www.medworm.com/index.php?rid=4197828&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc524766006025226%2F Abstract  The prognosis for patients diagnosed with heart failure has significantly improved over the past three decades; however, the disease still confers a high degree of morbidity and mortality. Current treatments for chronic heart failure have focused primarily on blocking neurohormonal signaling and optimizing hemodynamic parameters. Although significant resources have been devoted toward the development of new pharmaceutical therapies for heart failure, few new drugs have been designed to target myocardial metabolic pathways despite growing evidence that on a fundamental level chronic heart failure can be characterized as an imbalance between myocardial energy demand and supply. Disruptions in myocardial energy pathways are evident as the myocardium is unable to gene... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4197828 Mon, 22 Nov 2010 16:45:57 +0100 4197828 http://www.medworm.com/index.php?rid=4197827&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc684872454784r54%2F Abstract  In this review, we report on electrical modalities, which do not fit the definition of pacemaker, but increase cardiac performance either by direct application to the heart (e.g., post-extrasystolic potentiation or non-excitatory stimulation) or indirectly through activation of the nervous system (e.g., vagal or sympathetic activation). The physiological background of the possible mechanisms of these electrical modalities and their potential application to treat heart failure are discussed. Content Type Journal ArticleDOI 10.1007/s10741-010-9206-2Authors Richard N. Cornelussen, Research and Technology, Medtronic Bakken Research Center BV, Endepolsdomein 5, 6229 GW Maastricht, The NetherlandsVincent Splett, CRDM, Medtronic Moundsview, Minneapolis, MN USARuth Ni... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4197827 Mon, 22 Nov 2010 16:45:57 +0100 4197827 http://www.medworm.com/index.php?rid=4191541&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1q2292861g4456l5%2F Abstract  Echocardiography plays an important role in patient assessment before cardiac resynchronization therapy (CRT) and can monitor many of its mechanical effects in heart failure patients. Encouraged by the highly variable individual response observed in the major CRT trials, echocardiography-based measurements of mechanical dyssynchrony have been extensively investigated with the aim of improving response prediction and CRT delivery. Despite recent setbacks, these techniques have continued to develop in order to overcome some of their initial flaws and limitations. This review discusses the concepts and rationale of the available echocardiographic techniques, highlighting newer quantification methods and discussing some of the unsolved issues that need to be addressed... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4191541 Sat, 20 Nov 2010 17:51:04 +0100 4191541 http://www.medworm.com/index.php?rid=4191542&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj36203mk2v3436x1%2F Abstract  Abnormal electrical activation of the ventricles creates major abnormalities in cardiac mechanics. Local contraction patterns, as reflected by measurements of local strain, are not only out of phase, but often also show opposing length changes in early and late activated regions. As a consequence, the efficiency of cardiac pump function (the amount of stroke work generated by a unit of oxygen consumed) is approximately 30% lower in asynchronous than in synchronous hearts. Moreover, the amount of work performed in myocardial segments becomes considerably larger in late than in early activated regions. Cardiac Resynchronization Therapy (CRT) improves mechano-energetics of the previously asynchronous heart in various ways: it alleviates impediment of the abnormal con... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4191542 Fri, 19 Nov 2010 17:03:52 +0100 4191542 http://www.medworm.com/index.php?rid=4191543&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh450736h024x2003%2F Abstract  Atrial fibrillation (AF) and heart failure (HF) commonly coexist, and their co-presence is associated with adverse outcomes relating to thromboembolic events, HF progression, hospitalisation and death. Diastolic dysfunction (DD) is also frequently present in patients with HF and is an independent predictor of hospitalisation and mortality. The presence of DD is a strong predictor of incident AF in patients with HF. In this review, we provide mechanistic insight into pathophysiological processes that frequently promote the occurrence of AF, HF and DD and outline the yin-yang relationship between AF, DD and HF. More recently, invasive studies have also shown that asymptomatic paroxysmal atrial fibrillation (PAF) is a common phenomenon in HF patients. We examine comp... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4191543 Fri, 19 Nov 2010 17:03:50 +0100 4191543 http://www.medworm.com/index.php?rid=4160013&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3242874543x7234j%2F Abstract  The prevalence of heart failure due to coronary artery disease continues to increase, and it portends a worse prognosis than non-ischemic cardiomyopathy. Revascularization improves prognosis in these high-risk patients who have evidence of viability; therefore, optimal assessment of myocardial viability remains essential. Multiple imaging modalities exist for differentiating viable myocardium from scar in territories with contractile dysfunction. Given the multiple modalities available, choosing the best modality for a specific patient can be a daunting task. In this review, the physiology of myocardial hibernation and stunning will be reviewed. All the current methods available for assessing viability including echocardiography, cardiac magnetic resonance imaging... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4160013 Wed, 10 Nov 2010 17:27:37 +0100 4160013 http://www.medworm.com/index.php?rid=4109815&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3465q72475132344%2F Abstract  To date, cardiac resynchronization therapy remains the only treatment that enhances systolic function while improving long-term outcome and survival. Here, we review the molecular alterations associated with dyssynchronous heart failure and their reversibility induced by cardiac resynchronization therapy. We focus upon the molecular portrait of dyssynchronous heart failure and how cardiac resynchronization therapy influences electrophysiologic, metabolic and adrenergic pathways. Content Type Journal ArticleDOI 10.1007/s10741-010-9199-xAuthors Marc Vanderheyden, Cardiovascular Center, Onze Lieve Vrouwziekenhuis, Aalst, BelgiumChris Vrints, Cardiovascular Center, Onze Lieve Vrouwziekenhuis, Aalst, BelgiumJozef Bartunek, Cardiovascular Center, Onze Lieve Vrouwzie... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4109815 Sun, 24 Oct 2010 05:33:26 +0100 4109815 http://www.medworm.com/index.php?rid=4100927&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk432643251140960%2F Abstract  Ultrafiltration has been used in patients with decompensated HF and volume overload refractory to diuretics. Criteria for the initiation of renal replacement therapy (RRT) in the ICU are oliguria, anuria, urea, creatinine, Na and K blood concentrations, pulmonary edema unresponsive to diuretics, uncompensated metabolic acidosis, temperature >40°C, uremic complication, and overdose with a dialyzable toxin. Moreover, the treatment of acute renal failure requires a different style and philosophy from renal replacement therapy for chronic renal failure. The degree and the location of renal lesion, the entity, the gravity of the concomitant acute or chronic cardiac damage, the weight of a trauma, surgical stress, or septic complication they determine a variability ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4100927 Fri, 22 Oct 2010 18:28:33 +0100 4100927 http://www.medworm.com/index.php?rid=4068268&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv1u404r160137574%2F Abstract  Heart failure represents a common disease affecting approximately 5 million patients in the United States. Several conditions play an important role in the development and progression of heart failure, including abnormalities in myocardial blood flow and sympathetic innervation. Nuclear imaging represents the only imaging modality with sufficient sensitivity to assess myocardial blood flow and sympathetic innervation of the failing heart. Although nuclear imaging with single-photon emission computed tomography (SPECT) is most commonly used for the evaluation of myocardial perfusion, positron emission tomography (PET) allows absolute quantification of myocardial blood flow beyond the assessment of relative myocardial perfusion. Both techniques can be used for evalu... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4068268 Mon, 11 Oct 2010 16:49:03 +0100 4068268 http://www.medworm.com/index.php?rid=4046374&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgt23212456267133%2F Abstract  In the congestive heart failure state, autonomic dysregulation involves an increase in sympathetic tone and decrease in parasympathetic tone and is associated with increased mortality. It is possible that augmentation of the parasympathetic nervous system (PNS) with pharmacologic therapy may lead to improved symptoms and/or clinical outcomes. There are several new and established pharmacologic interventions that have been studied for their effect on the PNS, including antagonists of the renin–angiotensin system, beta-adrenergic antagonists, digoxin, and vasodilators. In this review, we discuss the current status of the published literature on pharmacologic influences on the PNS by both conventional and experimental drugs targeting heart failure as well as drugs t... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4046374 Tue, 05 Oct 2010 18:07:07 +0100 4046374 http://www.medworm.com/index.php?rid=4004978&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6786197mx306h34q%2F Content Type Journal ArticleDOI 10.1007/s10741-010-9192-4Authors Dennis V. Cokkinos, Biomedical Research Foundation, Academy of Athens, Onassis Cardiac Surgery Center, 356 Sygrou Ave, Kallithea, 17674 Athens, GreeceCostas Pantos, Department of Pharmacology, University of Athens, 75 Mikras Asias Ave, Goudi, 11527 Athens, Greece Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=4004978 Sat, 25 Sep 2010 17:00:24 +0100 4004978 http://www.medworm.com/index.php?rid=3999547&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg5l63516lr651620%2F Abstract  Anemia is common in Congestive Heart Failure (CHF) and is associated with an increased mortality, morbidity and progressive renal failure. The most common causes of the anemia in CHF are (1) the associated Chronic Kidney Disease (CKD), which causes depression of erythropoietin (EPO) production in the kidney, and (2) excessive cytokine production in CHF, which can cause both depression of erythropoietin production in the kidney and depression of erythropoietin response in the bone marrow. The cytokines can also induce iron deficiency by increasing hepcidin production from the liver, which both reduces gastrointestinal iron absorption and reduces iron release from iron stores located in the macrophages and hepatocytes. It appears that iron deficiency is very common ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3999547 Thu, 23 Sep 2010 16:58:46 +0100 3999547 http://www.medworm.com/index.php?rid=3978037&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl35617555l3347l1%2F Abstract  Heart failure is one of the most common, costly, disabling and growing diseases (McMurray and Pfeffer in Lancet 365(9474):1877–1889, 2005). Hyponatremia, conventionally defined as a serum-sodium concentration equal or less than 135 mmol/l (American Heart Association in Heart disease and stroke statistics—2007 update. American Heart Association, Dallas, 2007; Stewart et al. in Eur J Heart Fail 4:361–371, 2002), is a common phenomenon in patients with heart failure, with an incidence of 20–25% (Krumholz et al. in Arch Intern Med 157:e99–e104, 1997; Rosamond et al. in Circulation 117(4):e25–e146, 2008; Adrogue and Madias in N Engl J Med 342:1581–1589, 2000) and seems to be of prognostic importance in patients with heart failure (Luca et al. in Am J... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3978037 Mon, 13 Sep 2010 17:05:25 +0100 3978037 http://www.medworm.com/index.php?rid=3947848&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw511mv827q53m243%2F Abstract  Parasympathetic control of the heart via the vagus nerve is the primary mechanism that regulates beat-to-beat control of heart rate. Additionally, the vagus nerve exerts significant effects at the AV node, as well as effects on both atrial and ventricular myocardium. Vagal control is abnormal in heart failure, occurring at early stages of left ventricular dysfunction, and this reduced vagal function is associated with worse outcomes in patients following myocardial infarction and with heart failure. While central control mechanisms are abnormal, one of the primary sites of attenuated vagal control is at the level of the parasympathetic ganglion. It remains to be seen whether or not preventing or treating abnormal vagal control of the heart improves prognosis. ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3947848 Tue, 07 Sep 2010 07:07:49 +0100 3947848 http://www.medworm.com/index.php?rid=3916585&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F85h63362370313l6%2F Abstract  Improved understanding of the pathophysiology of salt and water homeostasis has provided a foundation for explaining the renal mechanisms of emerging therapies for heart failure, as well as why renal function might potentially be improved or harmed. These aspects are reviewed in this article for a number of newer therapies including adenosine, endothelin, and vasopressin receptor antagonists, as well as extracorporeal ultrafiltration. An appreciation of the complexity and sometimes opposing pathways of these approaches may explain their limited efficacy in early trials, in which there has not been a substantial improvement in patient or renal outcomes. In that there is often a balance between beneficial and maladaptive receptor actions and neurohumoral responses, ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3916585 Mon, 30 Aug 2010 05:59:04 +0100 3916585 http://www.medworm.com/index.php?rid=3865952&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg345v657417207q7%2F Abstract  A wide variety of cardiac disease states can induce remodelling and lead to the functional consequence of heart failure. These complex disease states involve a plethora of parallel signal transduction events, which may be associated with tissue injury or tissue repair. Innate immunity is activated in hearts injured in different ways, evident as cytokine release from the heart, activation of toll-like receptors involved in recognizing danger, and activation of the transcription factor nuclear factor kappa B. Nuclear factor kappa B regulates gene programmes involved in inflammation as well as the resolution of inflammation. The impact of this is an enigma; while cytokines, toll-like receptors, and nuclear factor kappa B appear to elicit myocardial protection in stud... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3865952 Mon, 09 Aug 2010 05:44:37 +0100 3865952 http://www.medworm.com/index.php?rid=3828904&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F232716135737t543%2F Content Type Journal ArticleDOI 10.1007/s10741-010-9189-zAuthors Bodh I. Jugdutt, University of Alberta Division of Cardiology, Department of Medicine and Cardiovascular Research Group, Faculty of Medicine, 2C2 Walter MacKenzie Health Sciences Centre Edmonton AB T6G 2R7 Canada Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3828904 Wed, 04 Aug 2010 20:50:03 +0100 3828904 http://www.medworm.com/index.php?rid=3818093&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F09843167676h2276%2F Abstract  Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic cytokine usually used in the treatment of patients with cancer. Studies have shown regenerative properties of bone marrow stem cell mobilization due to G-CSF in animals. Moreover, others effects related to G-CSF and independent of tissue regeneration were shown to be protective. As a result, this cytokine has been tested as a therapy for ischemic heart failure in humans. However, when this treatment was evaluated in clinical trials, the beneficial effects seen in small animals were not confirmed in infarcted patients. Thus, we sought to review the effects of G-CSF after an ischemic insult and on the progression of heart failure in animals and humans. Content Type Journal ArticleDOI 10.1007/s10741... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3818093 Mon, 02 Aug 2010 20:11:57 +0100 3818093 http://www.medworm.com/index.php?rid=3808128&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F15761616l2804223%2F Abstract  Chronic ischemia or pressure overload decreases thyroid hormone (TH) signaling and activates the fetal gene program in the heart. While these features are of physiologic importance in the developing heart, their respective roles in the postnatal heart are debated. Administration of TH can prevent the changes of the fetal gene program and rebuild the heart after an “index event” such as ischemia. TH affects cardiac remodeling by limiting reperfusion injury, and, at later states, by inducing distinct changes in cardiac chamber geometry in a time-dependent manner. Furthermore, administration of TH can convert pathologic to physiologic hypertrophy. These effects are the result of favorable cellular remodeling. While preliminary clinical studies provide encouraging... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3808128 Thu, 29 Jul 2010 16:07:10 +0100 3808128 http://www.medworm.com/index.php?rid=3791852&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe579462512534t13%2F Abstract  In heart failure, an inflammatory response may occur. The relationship between inflammatory cytokines, NOS and heart failure progression remains uncertain. Parasympathetic activation can affect heart rate and AV conduction. In heart failure, a relationship between the vagus nerve and the inflammatory response has been proposed. Vagal nerve stimulation can modulate the inflammatory response and affect specific inflammatory mediators including nitric oxide that may be contributory to continued or progressive heart failure. Therefore, vagal nerve stimulation may have beneficial effects that are independent from heart rate or AV conduction in heart failure. Challenges remain regarding the relationship between specific inflammatory markers and heart failure and how to ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3791852 Sat, 24 Jul 2010 20:05:58 +0100 3791852 http://www.medworm.com/index.php?rid=3791851&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn3t730g7380868x8%2F Abstract  A heart under chronic stress undergoes cardiac remodelling, a process that comprises structural and functional changes including cardiomyocyte hypertrophy, interstitial fibrosis, contractile dysfunction, cell death and ventricular dilatation. Reactive oxygen species (ROS)-dependent modulation of intracellular signalling is implicated in the development of cardiac remodelling. Among the different ROS sources that are present in the heart, NADPH oxidases (NOXs) are particularly important in redox signalling. NOX isoforms are expressed in multiple cell types including cardiomyocytes, fibroblasts, endothelial cells and inflammatory cells—with the two main isoforms expressed in the heart being NOX2 and NOX4. Recent studies indicate that NOX-dependent signalling is in... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3791851 Sat, 24 Jul 2010 20:05:58 +0100 3791851 http://www.medworm.com/index.php?rid=3791853&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fjj7474270132p808%2F Abstract  Despite remarkable advances in therapy, heart failure remains a leading cause of morbidity and mortality. Although enhanced β-adrenergic receptor stimulation is part of normal physiologic adaptation to either the increase in physiologic demand or decrease in cardiac function, chronic β-adrenergic stimulation has been associated with increased mortality and morbidity in both animal models and humans. For example, overexpression of cardiac Gsα or β-adrenergic receptors in transgenic mice results in enhanced cardiac function in young animals, but with prolonged overstimulation of this pathway, cardiomyopathy develops in these mice as they age. Similarly, chronic sympathomimetic amine therapy increases morbidity and mortality in patients with heart failure. Conver... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3791853 Sat, 24 Jul 2010 13:49:01 +0100 3791853 http://www.medworm.com/index.php?rid=3747810&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4k440mt3h7381867%2F Abstract  As more patients survive myocardial infarctions, the incidence of heart failure increases. After an infarction, the human heart undergoes a series of structural changes, which are governed by cellular and molecular mechanisms in a pathological metamorphosis termed “remodeling.” This review will discuss the current developments in our understanding of these molecular and cellular events in remodeling and the various pharmacological, cellular and device therapies used to treat, and potentially retard, this condition. Specifically, this paper will examine the neurohormonal activity of the renin–angiotensin–aldosterone axis and its molecular effects on the heart. The emerging understanding of the extra-cellular matrix and the various active molecules within it... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3747810 Sat, 10 Jul 2010 06:46:37 +0100 3747810 http://www.medworm.com/index.php?rid=3747811&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk2n4452453t71h77%2F Abstract  A primary concern in the utilization of implantable neural interfaces for the treatment of medical diseases is to follow the Hippocratic dictum: First, do no harm. If we are to avoid harm to the Vagus nerve in our use of stimulatory electrodes in the treatment of heart failure, we must understand the structural and functional elements that comprise peripheral nerves, their susceptibility to various types of injury that might be expected to occur secondary to functional electrical stimulation and how to separate the various components of the response of peripheral nervous system elements to stresses that may occur in the complex interactions that take place between electrode and nerve. To this end, we review the functional histology of peripheral nerve, followed by ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3747811 Sat, 10 Jul 2010 06:46:36 +0100 3747811 http://www.medworm.com/index.php?rid=3700428&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F429w4j1647n21v3g%2F Abstract  The methods used to assess cardiac parasympathetic (cardiovagal) activity and its effects on the heart in both humans and animal models are reviewed. Heart rate (HR)-based methods include measurements of the HR response to blockade of muscarinic cholinergic receptors (parasympathetic tone), beat-to-beat HR variability (HRV) (parasympathetic modulation), rate of post-exercise HR recovery (parasympathetic reactivation), and reflex-mediated changes in HR evoked by activation or inhibition of sensory (afferent) nerves. Sources of excitatory afferent input that increase cardiovagal activity and decrease HR include baroreceptors, chemoreceptors, trigeminal receptors, and subsets of cardiopulmonary receptors with vagal afferents. Sources of inhibitory afferent input incl... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3700428 Fri, 25 Jun 2010 16:55:30 +0100 3700428 http://www.medworm.com/index.php?rid=3700427&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc971023t01238858%2F This article reviews the background of sympathetic–parasympathetic interactions focusing on the best direct evidence available, namely direct neural recordings of the activity of single vagal and sympathetic fibers directed to the heart. It examines indirect but highly reliable markers of this interaction as they can be studied in the clinical setting of ischemic heart disease and of heart failure, focusing primarily on the experimental and clinical studies of baroreflex sensitivity. It concludes by drawing inferences likely to lead to a novel approach to the management of heart failure, resulting from the knowledge gained about the vagal control of the heart and based on electrical vagal stimulation. Content Type Journal ArticleDOI 10.1007/s10741-010-9179-1Authors Peter J. S... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3700427 Fri, 25 Jun 2010 16:55:30 +0100 3700427 http://www.medworm.com/index.php?rid=3692381&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9g603216p7103345%2F Abstract  Cardiac dysfunction is a well-recognized complication of severe sepsis and septic shock. Cardiac dysfunction in sepsis is characterized by ventricular dilatation, reduction in ejection fraction and reduced contractility. Initially, cardiac dysfunction was considered to occur only during the “hypodynamic” phase of shock. But we now know that it occurs very early in sepsis even during the “hyperdynamic” phase of septic shock. Circulating blood-borne factors were suspected to be involved in the evolution of sepsis induced cardiomyopathy, but it is not until recently that the cellular and molecular events are being targeted by researchers in a quest to understand this enigmatic process. Septic cardiomyopathy has been the subject of investigation for nearly hal... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3692381 Wed, 23 Jun 2010 08:22:32 +0100 3692381 http://www.medworm.com/index.php?rid=3692382&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg52tghr817788g52%2F Abstract  TNFα is crucially involved in the pathogenesis and progression of myocardial ischemia/reperfusion injury and heart failure. The formation and release of TNFα and its downstream signal transduction cascade following activation of its two receptor subtypes are characterized. Myocardial TNFα and TNF receptor activation have an ambivalent role in myocardial ischemia/reperfusion injury and protection from it. Excessive TNFα expression and subsequent cardiomyocyte TNF receptor type 1 stimulation induce contractile dysfunction, hypertrophy, fibrosis and cell death, while a lower TNFα concentration and subsequent cardiomyocyte TNF receptor type 2 stimulation are protective. Apart from its concentration and receptor subtype, the myocardial action of TNFα depends on t... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3692382 Wed, 23 Jun 2010 08:22:30 +0100 3692382 http://www.medworm.com/index.php?rid=3677802&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9225x28707728384%2F Abstract  Enhancing vagal tone by delivering electrical stimulation to the vagal nerves (VNS) is emerging as a promising novel therapy in heart failure. In addition, VNS is already an FDA-approved therapy for refractory epilepsy and depression. Besides its well-known negative chronotropic, inotropic, and dromotropic effects, VNS has profound effects on cardiac electrophysiology and arrhythmogenesis. This review summarizes current knowledge about the complex relationship between VNS and cardiac arrhythmias. Specifically, the focus is on VNS capability to become a therapeutic strategy along with important electrophysiological alterations that may constitute a potential arrhythmogenic substrate and become a clinical concern. Content Type Journal ArticleDOI 10.1007/s10741-0... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3677802 Fri, 18 Jun 2010 10:37:28 +0100 3677802 http://www.medworm.com/index.php?rid=3677803&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq1410t84t775k261%2F Abstract  Diabetes mellitus is one of the leading causes of death, and the majority of these deaths are associated with cardiovascular diseases. Development and progression of myocardial infarction leading to heart failure is much more complex and multifactorial in diabetics compared with non-diabetics. Despite significant advances in pharmacological interventions and surgical techniques, the disease progression leading to diabetic end-stage heart failure remains very high. Recently, cell therapy has gained much attention as an alternative approach to treat various heart diseases. However, transplanted stem cell studies in diabetic animal models are very limited. In this review, we discuss the pathogenesis of the diabetic infarcted heart and the potential of stem cell thera... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3677803 Fri, 18 Jun 2010 10:37:27 +0100 3677803 http://www.medworm.com/index.php?rid=3667739&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb218mu2883x29320%2F Abstract  Left ventricular non-compaction, also known as left ventricular hypertrabeculation (LVHT), is a morphological abnormality of the left ventricular myocardium, characterised by a meshwork of myocardial strings, interlacing, and orderless in arrangement. LVHT is most frequently located in the apex and the lateral wall and may occur with or without other congenital or acquired cardiac abnormalities. LVHT is believed to be congenital in the majority of the cases but may develop during life in single cases (acquired LVHT). Congenital LVHT is believed to result from defective late-stage embryonic development of the myocardial architecture. The pathogenesis of acquired LVHT remains speculative. LVHT is most frequently found on transthoracic echocardiography and cardiac MR... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3667739 Mon, 14 Jun 2010 14:08:47 +0100 3667739 http://www.medworm.com/index.php?rid=3667738&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk86tp82q60w1t432%2F Abstract  The elderly population (age ≥ 65 years) has been increasing worldwide. In North America and Europe, both heart failure (HF) and ST-segment elevation MI (STEMI) are more prevalent in the elderly. Morbidity, hospitalizations and costs associated with HF are higher in the elderly. Despite improved therapies, the bulk of cardiovascular deaths occur in the elderly. Survivors of acute STEMI develop progressive ventricular remodeling that leads to HF. There are several reasons for the increased HF burden in the elderly. First, there is a lack of clinical trial data exclusively in elderly patients for specific therapy of adverse remodeling post-STEMI and HF with low ejection fraction (HF/low-EF) or HF with preserved ejection fraction (HF/PEF). Second, there is the ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3667738 Mon, 14 Jun 2010 14:08:47 +0100 3667738 http://www.medworm.com/index.php?rid=3653540&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm54435608500120w%2F Abstract  During normal aging, the heart undergoes functional, morphological and cellular changes. Although aging per se does not lead to the expression of heart failure, it is likely that age-associated changes lower the threshold for the manifestation of signs and symptoms of heart failure. In patients, the susceptibility, age of onset and pace of progression of heart failure are highly variable. The presence of conventional risk factors cannot completely explain this variability. Accumulation of DNA damage and telomere attrition results in an increase in cellular senescence and apoptosis, resulting in a decrease in the number and function of cells, contributing to the overall tissue and organ dysfunction. Biological aging, characterized by reduced telomere length, provid... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3653540 Wed, 09 Jun 2010 09:25:53 +0100 3653540 http://www.medworm.com/index.php?rid=3587051&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr12lm04q6360m567%2F We present a review of the numerous studies evaluating the effects of FES in CHF, focusing on its main effects on skeletal myopathy reversal, exercise tolerance improvement and quality of life modification. Content Type Journal ArticleDOI 10.1007/s10741-010-9171-9Authors Apostolos Karavidas, G. Gennimatas’ General Hospital of Athens Mesogion 156 Athens GreeceSophia M. Arapi, G. Gennimatas’ General Hospital of Athens Mesogion 156 Athens GreeceVlassios Pyrgakis, G. Gennimatas’ General Hospital of Athens Mesogion 156 Athens GreeceStamatis Adamopoulos, Onassis Cardiac Surgery Center Second Cardiology Department Athens Greece Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3587051 Thu, 20 May 2010 16:57:54 +0100 3587051 http://www.medworm.com/index.php?rid=3509075&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F38797801qh301263%2F Abstract  Hypertension, atherosclerosis, and resultant chronic heart failure (HF) reach epidemic proportions among older persons, and the clinical manifestations and the prognoses of these worsen with increasing age. Thus, age per se is the major risk factor for cardiovascular disease. Changes in cardiac cell phenotype that occur with normal aging, as well as in HF associated with aging, include deficits in ß-adrenergic receptor (ß-AR) signaling, increased generation of reactive oxygen species (ROS), and altered excitation–contraction (EC) coupling that involves prolongation of the action potential (AP), intracellular Ca2+ (Cai2+) transient and contraction, and blunted force- and relaxation-frequency responses. Evidence suggests that altered sarcoplasmic reticulum (SR) C... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3509075 Sat, 24 Apr 2010 08:08:16 +0100 3509075 http://www.medworm.com/index.php?rid=3495248&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fhp370tqt3j75246g%2F Abstract  Multiple in vitro and in vivo studies showed that the signal transducer and activator of transcription 3 (STAT3) protein is involved in cardiomyocyte protection and hypertrophy and via paracrine pathways impacts on the non-myocyte compartment, i.e., the vasculature and the extracellular matrix. In this regard, STAT3 interacts with a broad range of cellular and molecular mechanisms that direct remodeling processes in cardiac physiology (exercise, pregnancy) and pathophysiology (pressure overload, ischemia/reperfusion, myocardial infarction, and cardiotoxic agents). STAT3 is constitutively activated by a multitude of factors including cytokines, growth factors, neurohormones, mechanical load, and ischemia. It acts as a signaling molecule, a transcription factor and ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3495248 Wed, 21 Apr 2010 09:20:34 +0100 3495248 http://www.medworm.com/index.php?rid=3491661&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh0p53471mj572713%2F Abstract  Fibrosis is a fundamental component of the adverse structural remodeling of myocardium present in the failing heart. Replacement fibrosis appears at sites of previous cardiomyocyte necrosis to preserve the structural integrity of the myocardium, but not without adverse functional consequences. The extensive nature of this microscopic scarring suggests cardiomyocyte necrosis is widespread and the loss of these contractile elements, combined with fibrous tissue deposition in the form of a stiff in-series and in-parallel elastic elements, contributes to the progressive failure of this normally efficient muscular pump. Cellular and molecular studies into the signal-transducer-effector pathway involved in cardiomyocyte necrosis have identified the crucial pathogenic ro... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3491661 Tue, 20 Apr 2010 11:06:15 +0100 3491661 http://www.medworm.com/index.php?rid=3491662&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq2m08932173k7t31%2F Abstract  Increased circulating and intracardiac levels of proinflammatory cytokines have been associated with chronic heart failure. Following an initial insult, the increased production of proinflammatory cytokines, including TNF-α, IL-6, IL-1, and IL-18, jeopardizes the surrounding tissue through propagation of the inflammatory response and direct effects on the cardiac myocyte structure and function. Cardiac myocyte hypertrophy, contractile dysfunction, cardiac myocyte apoptosis, and extracellular matrix remodeling contribute enormously to the development and progression of chronic heart failure. Despite the identification of efficacious pharmacological regimens and introduction of mechanical interventions, chronic heart failure remains among the leading causes of mort... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3491662 Tue, 20 Apr 2010 11:06:14 +0100 3491662 http://www.medworm.com/index.php?rid=3469163&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx1r7554753u63v90%2F Abstract  Heart failure is a progressive disease, leading to reduced quality of life and premature death. Adverse ventricular remodeling involves changes in the balance between cardiomyocyte protein synthesis and degradation, forcing these myocytes in equilibrium between life and death. In this context, autophagy has been recognized to play a role in the pathophysiology of heart failure. At basal levels, autophagy performs housekeeping functions, maintaining cardiomyocyte function and ventricular mass. Autophagy also occurs in the failing human heart, and upregulation has been reported in animal models of pressure overload–induced heart failure. Although the factors that determine whether autophagy will be protective or detrimental are not well known, the level and durati... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3469163 Sat, 10 Apr 2010 07:49:22 +0100 3469163 http://www.medworm.com/index.php?rid=3445010&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Frm3u7u86r16104l2%2F Abstract  A growing body of evidence supports the hypothesis that autocrine and paracrine mechanisms, mediated by factors released by the resident cardiac cells, could play an essential role in the reparative process of the failing heart. Such signals may influence the function of cardiac stem cells via several mechanisms, among which the most extensively studied are cardiomyocyte survival and angiogenesis. Moreover, besides promoting cytoprotection and angiogenesis, paracrine factors released by resident cardiac cells may alter cardiac metabolism and extracellular matrix turnover, resulting in more favorable post-injury remodeling. It is reasonable to believe that critical intracellular signals are activated and modulated in a temporal and spatial manner exerting different... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3445010 Sat, 03 Apr 2010 07:16:15 +0100 3445010 http://www.medworm.com/index.php?rid=3445011&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9510024655vj167x%2F Abstract  The elderly population (age ≥65) is increasing and with it morbidity, hospitalizations, costs and mortality due to heart failure (HF). HF is a progressive disorder that is superimposed on an on-going aging process. The two broad categories of HF, HF with left ventricular (LV) systolic dysfunction or low ejection fraction (HF/low-EF) and HF with preserved ejection fraction (HF/PEF) are equally prevalent in the elderly. Trials of therapy for HF/low-EF in primarily non-elderly patients showed mortality benefit in elderly patients. In contrast, trials for HF/PEF have not shown mortality benefit in elderly or non-elderly patients. HF pharmacotherapy in the elderly is challenging and needs to be individualized and consider several aging-related changes. More research ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3445011 Sat, 03 Apr 2010 07:16:14 +0100 3445011 http://www.medworm.com/index.php?rid=3386332&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F86r10731k8806133%2F Abstract  Resveratrol, a polyphenol phytoalexin, present in red wine and grapes possesses diverse biochemical and physiological properties, including estrogenic, antiplatelet, and anti-inflammatory properties as well as a wide range of health benefits ranging from chemoprevention to cardioprotection. Recently, several studies described resveratrol as an anti-aging compound. This review focuses on the anti-aging aspects of resveratrol, the possible mechanisms of action, and emerging controversy on its life-prolonging ability. It appears that resveratrol can induce the expression of several longevity genes including Sirt1, Sirt3, Sirt4, FoxO1, Foxo3a and PBEF and prevent aging-related decline in cardiovascular function including cholesterol level and inflammatory response, but ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3386332 Thu, 18 Mar 2010 15:36:57 +0100 3386332 http://www.medworm.com/index.php?rid=3360418&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Faj08552540511724%2F Abstract  Despite a wide range of therapeutic interventions, the prognosis for most patients with heart failure remains poor. The identification of stem cells with the ability to generate cardiomyocytes and vascular cells and promote local repair and survival pathways has highlighted the ability of the heart to undergo regeneration and potentially provides a new therapeutic strategy for treatment of the failing heart. In recent years, however, clinical trials aimed at exploiting the beneficial effects of stem and progenitor cells to treat patients with cardiovascular disease have resulted in mild improvements at best, suggesting that these cells and/or the conditions in which they find themselves are not conducive to cardiac repair. Heart failure is most prevalent among old... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3360418 Thu, 11 Mar 2010 18:24:42 +0100 3360418 http://www.medworm.com/index.php?rid=3355765&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd342417k43702884%2F Abstract  Heart failure is strongly associated with aging. Elderly patients with heart failure often have preserved systolic function exhibiting left ventricular hypertrophy accompanied by a decline in diastolic function. Experimental studies have demonstrated that age-related cardiac fibrosis plays an important role in the pathogenesis of diastolic heart failure in senescent hearts. Reactive oxygen species and angiotensin II are critically involved in fibrotic remodeling of the aging ventricle; their fibrogenic actions may be mediated, at least in part, through transforming growth factor (TGF)-β. The increased prevalence of heart failure in the elderly is also due to impaired responses of the senescent heart to cardiac injury. Aging is associated with suppressed inflammat... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3355765 Wed, 10 Mar 2010 16:17:30 +0100 3355765 http://www.medworm.com/index.php?rid=3355764&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw00ggp55g72t1t31%2F Abstract  Heart disease is important in elderly patients. The treatment of myocardial infarction and heart failure are particularly important and will continue to play an important role across the globe. Advances in treatment of myocardial infarction have made tremendous inroads in the short and long term survival of patients, young and old, however, many currently employed strategies have not been tested in patients who are elderly, who paradoxically, form a growing subset of patients with heart disease. A similar paradigm exists in heart failure for both diagnosis and treatment. Attention to this issue is important when selecting treatment strategies and a focus on the goals of care is critical when decisions for care must be undertaken. Content Type Journal ArticleDO... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3355764 Wed, 10 Mar 2010 16:17:30 +0100 3355764 http://www.medworm.com/index.php?rid=3355766&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F54028752274l4178%2F Abstract  Adiponectin is an adipose tissue-derived adipokine abundant in human plasma. Increasing evidence from experimental studies suggests that adiponectin plays a protective role in the cardiovascular system. However, epidemiological studies revealed that high levels of adiponectin were associated with increased mortality and severity of congestive heart failure. Furthermore, several prospective studies indicated that high levels of adiponectin were positively correlated with increased total and cardiovascular disease mortality in the elderly. These results are completely opposite to our expectation based on the beneficial effects of adiponectin. Clinical observations demonstrated that plasma adiponectin levels were positively associated with B-type natriuretic peptide ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3355766 Wed, 10 Mar 2010 16:17:29 +0100 3355766 http://www.medworm.com/index.php?rid=3240976&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp3242g608g035011%2F Abstract  Cardiovascular disease is one of the leading causes of death in the elderly. Much of the morbidity and mortality in the elderly is attributable to acute ischemic events leading to myocardial infarction (MI) and death of cardiac myocytes. Evidence has been provided that aging associated with adverse remodeling post MI as demonstrated by less effective myocardial repair, greater infarct expansion, and septal hypertrophy. Expression of osteopontin (OPN) increases in the heart post MI. Transgenic mice studies suggest that increased expression of OPN plays a protective role in post-MI LV remodeling by modulating collagen deposition and fibrosis. OPN, a multifunctional protein, has the potential to influence the molecular and cellular changes associated with infarct hea... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3240976 Tue, 02 Feb 2010 17:51:25 +0100 3240976 http://www.medworm.com/index.php?rid=3209632&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb47188u823816454%2F Abstract  Initial research established the feasibility of exercise training in patients with heart failure, as well as associated physiological benefits. This review summarizes the findings from over two dozen single-site studies that address the effect of exercise training on exercise capacity and cardiovascular and peripheral function. In addition, it incorporates the results from two meta-analyses and a recently completed multi-center trial, all of which studied the effects of exercise training on clinical outcomes. The major conclusions from these studies are that exercise training is safe; improves health status and exercise capacity; helps attenuate much of the abnormal pathophysiology that develops with heart failure; and yields a modest reduction in clinical events.... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3209632 Mon, 25 Jan 2010 17:01:05 +0100 3209632 http://www.medworm.com/index.php?rid=3040898&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F745v75961181px24%2F Abstract  Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder caused by the absence of dystrophin, a sarcolemmal protein which links the cytoskeleton to the extracellular matrix by interacting with a large number of proteins. Heart failure is a classic complication of this disease. The authors review the pathogenesis and therapeutics of cardiac involvement in DMD. Content Type Journal ArticleDOI 10.1007/s10741-009-9156-8Authors Abdallah Fayssoil, University of Medicine and Dentistry of New Jersey Camden NJ USAOlivier Nardi, Raymond Poincaré Hospital, AP-HP Intensive Care Unit Garches FranceDavid Orlikowski, Raymond Poincaré Hospital, AP-HP Intensive Care Unit Garches FranceDjillali Annane, Raymond Poincaré Hospital, AP-HP Intensive Care Unit Garches Fran... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3040898 Fri, 27 Nov 2009 07:06:28 +0100 3040898 http://www.medworm.com/index.php?rid=2996831&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe7850u66221u0v76%2F Content Type Journal ArticleCategory Book ReviewDOI 10.1007/s10741-009-9155-9Authors Sidney Goldstein, Wayne State University Detroit MI USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2996831 Fri, 13 Nov 2009 18:28:44 +0100 2996831 http://www.medworm.com/index.php?rid=2947879&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0454480241703821%2F Abstract  Treatment with inotropic agents is one of the most controversial topics in heart failure. Initial enthusiasm, based on strong pathophysiological rationale and apparent empirical efficacy, has been progressively limited by results of controlled trials and registries showing poorer outcomes of the patients on inotropic therapy. The use of these agents remains, however, potentially indicated in a significant proportion of patients with low cardiac output, peripheral hypoperfusion and end-organ dysfunction caused by heart failure. Limitations of inotropic therapy seem to be mainly related to their mechanisms of action entailing arrhythmogenesis, peripheral vasodilation, myocardial ischemia and damage, and possibly due to their use in patients without a clear indicatio... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2947879 Thu, 29 Oct 2009 19:51:20 +0100 2947879 http://www.medworm.com/index.php?rid=2944975&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa85845x1jr061265%2F This article focuses on some of the challenges related to the assessment of RV function in the setting of the RV’s unique anatomic, physiologic, conventional and newer echocardiographic aspects, and therapeutic implications. The majority of proposed methods of echocardiographic assessment of RV function are based on volumetric approximations of the RV. Such approaches have inherent limitations, first as volume-related measures such as EF are load dependent, second because of the complex geometry of the RV. The issue of RV geometry is usually overcome using geometry-independent parameters such as tricuspid annular excursion and the Tei index. The recent introduction of real-time three-dimensional echocardiography and myocardial imaging echocardiography (tissue Doppler imaging, 1D-st... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2944975 Thu, 29 Oct 2009 07:23:04 +0100 2944975 http://www.medworm.com/index.php?rid=2810719&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc8520pn66v3213gu%2F Abstract  It is now becoming clear that two major systems namely the sympathetic nervous system and the renin-angiotensin system are activated in response to ischemic injury; these result in the elevation of plasma catecholamines and angiotensin II during the development of myocardial infarction as well as congestive heart failure. Although plasma levels of several other hormones including aldosterone, endothelin, vasopressin, natriuretic peptides, growth factors and inflammatory cytokines are also increased in heart failure, their relationship with changes in catecholamine and/or angiotensin levels as well as their significance for the induction of congestive heart failure are poorly understood. In this article we have examined the evidence regarding the role of endothelin... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2810719 Fri, 18 Sep 2009 06:15:39 +0100 2810719 http://www.medworm.com/index.php?rid=2810720&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq073162j71m68777%2F Abstract  The normal left ventricular shape has been defined as prolate ellipsoid. This shape is an adaptation to evolution. A knowledge of its unique macro and micro architecture forms the cornerstone in the understanding of its complex function. The left ventricle has a unique architecture with three different myofiber orientations, the longitudinal, circumferential and oblique fibers. The oblique orientation of fibers is essential for effective clockwise and anticlockwise torsional movements during systole and diastole, for optimal ventricular ejection and filling. The orientation and fiber angle decide the shape of the ventricle. An ellipsoid shape is vital for optimal function. Pathological disease states such as ischemic heart disease, valvular heart disease and cardi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2810720 Wed, 16 Sep 2009 12:56:36 +0100 2810720